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Sample records for clinical measurements radiological

  1. Prediction of peak pressure from clinical and radiological measurements in patients with diabetes

    PubMed Central

    Guldemond, Nick A; Leffers, Pieter; Walenkamp, Geert HIM; Schaper, Nicolaas C; Sanders, Antal P; Nieman, Fred HM; van Rhijn, Lodewijk W

    2008-01-01

    Background Various structural and functional factors of foot function have been associated with high local plantar pressures. The therapist focuses on these features which are thought to be responsible for plantar ulceration in patients with diabetes. Risk assessment of the diabetic foot would be made easier if locally elevated plantar pressure could be indicated with a minimum set of clinical measures. Methods Ninety three patients were evaluated through vascular, orthopaedic, neurological and radiological assessment. A pressure platform was used to quantify the barefoot peak pressure for six forefoot regions: big toe (BT) and metatarsals one (MT-1) to five (MT-5). Stepwise regression modelling was performed to determine which set of the clinical and radiological measures explained most variability in local barefoot plantar peak pressure in each of the six forefoot regions. Comprehensive models were computed with independent variables from the clinical and radiological measurements. The difference between the actual plantar pressure and the predicted value was examined through Bland-Altman analysis. Results Forefoot pressures were significant higher in patients with neuropathy, compared to patients without neuropathy for the whole forefoot, the MT-1 region and the MT-5 region (respectively 138 kPa, 173 kPa and 88 kPa higher: mean difference). The clinical models explained up to 39 percent of the variance in local peak pressures. Callus formation and toe deformity were identified as relevant clinical predictors for all forefoot regions. Regression models with radiological variables explained about 26 percent of the variance in local peak pressures. For most regions the combination of clinical and radiological variables resulted in a higher explained variance. The Bland and Altman analysis showed a major discrepancy between the predicted and the actual peak pressure values. Conclusion At best, clinical and radiological measurements could only explain about 34

  2. Objective structured clinical examination in radiology

    PubMed Central

    Agarwal, Anurag; Batra, Bipin; Sood, AK; Ramakantan, Ravi; Bhargava, Satish K; Chidambaranathan, N; Indrajit, IK

    2010-01-01

    There is a growing need for introducing objective structured clinical examination (OSCE) as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed “key-list” that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as “manned” or “unmanned” stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT) analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations. PMID:20607015

  3. Objective structured clinical examination in radiology.

    PubMed

    Agarwal, Anurag; Batra, Bipin; Sood, Ak; Ramakantan, Ravi; Bhargava, Satish K; Chidambaranathan, N; Indrajit, Ik

    2010-05-01

    There is a growing need for introducing objective structured clinical examination (OSCE) as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed "key-list" that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as "manned" or "unmanned" stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT) analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations.

  4. Telemetry of Aerial Radiological Measurements

    SciTech Connect

    H. W. Clark, Jr.

    2002-10-01

    Telemetry has been added to National Nuclear Security Administration's (NNSA's) Aerial Measuring System (AMS) Incident Response aircraft to accelerate availability of aerial radiological mapping data. Rapid aerial radiological mapping is promptly performed by AMS Incident Response aircraft in the event of a major radiological dispersal. The AMS airplane flies the entire potentially affected area, plus a generous margin, to provide a quick look at the extent and severity of the event. The primary result of the AMS Incident Response over flight is a map of estimated exposure rate on the ground along the flight path. Formerly, it was necessary to wait for the airplane to land before the map could be seen. Now, while the flight is still in progress, data are relayed via satellite directly from the aircraft to an operations center, where they are displayed and disseminated. This permits more timely utilization of results by decision makers and redirection of the mission to optimize its value. The current telemetry capability can cover all of North America. Extension to a global capability is under consideration.

  5. Otologic radiology with clinical correlations

    SciTech Connect

    Ruenes, R.; De la Cruz, A.

    1986-01-01

    This manual covers developments in the radiologic diagnosis of otologic problems. To demonstrate the appearance of each disorder comprehensively, a large number of radiographs are included, many of them annotated to highlight both diagnostic signs and the subtle aspects of normal pathologic anatomy. Contents: X-ray and Imaging Techniques and Anatomy. Congenital Malformations. Middle and External Ear Infections. Otosclerosis and Otospongiosis. Temporal Bone Fractures. The Facial Nerve. Tumors of the Temporal Bone and Skull Base. Tumors of the Cerebellopontine Angle. Cochlear Implants.

  6. Clinical relevance of radiologic examination of the skeleton and bone density measurements in osteoporosis of old age

    SciTech Connect

    Kuester, W.; Seidl, G.; Linkesch, W.; Kotscher, E.; Kovarik, J.; Willvonseder, R.; Kovarik, J.; Willvonseder, R.; Dorda, W.

    1981-10-01

    For the diagnosis of primary osteoporosis, various semiquantitative radiologic methods were compared in 149 unselected patients, aged over 50 years. Crush fracture syndrome (CFS), lumbar spine index (LSI), and Singh Index (SI) were assessed by three radiologists and after reevaluation, the intra- and interobserver errors were calculated. The reliability of the subjective grading was improved by joint and repeated reading of the radiographs. Additionally, the peripheral trabecular bone content was measured by photon absorption densitometry (PAD). To test the value of the various semiquantitative methods. LSI, Si, and PAD have been compared with sex-matching before and after separation into age in decades in CFS-positive and CFS-negative patients. In an attempt to differentiate osteoporotics and non-osteoporotics by CFS, our results indicate that CFS-positive and CFS-negative males cannot be separated by LSI, Si, and PAD, whereas in females these methods can discriminate irrespective of the age in decades. However, in age related groups, only SI can discriminate significantly between CFS-positive and CFS-negative females. Correlation of the semiquantitative methods, regardless of the diagnosis of a CFS, revealed a significant correlation-between SI and PAD, but no correlation between LSI and SI, and LSI and PAD, respectively.

  7. Urologic pathology with clinical and radiologic correlations

    SciTech Connect

    Someren, A.

    1989-01-01

    This book is devoted to the kidneys, urinary passages, renal transplantation, male genitalia, and adrenal glands. Each chapter has the same format: congenital conditions are discussed then, inflammatory and nonneoplastic disorders; and, finally, neoplasms. For each disease process, the clinical presentation, radiologic findings, pathologic characteristics, therapy, and prognosis are discussed.

  8. Mayo Clinic Jacksonville electronic radiology practice

    NASA Astrophysics Data System (ADS)

    Morin, Richard L.; Berquist, Thomas H.; Rueger, Wolfgang

    1996-05-01

    We have begun a project to implement an Electronic (Filmless) Radiology Practice (ERP) at Mayo Clinic Jacksonville. This project is integrated with the implementation of a project (Automated Clinical Practice--ACP) to eliminate circulation and archival of the current paper Medical Record. The ERP will result in elimination of screen/film radiography and the transmittal of film throughout the institution by the end of 1996. In conjunction with the ACP, paper and film will not circulate within the clinic by the end of this year.

  9. Measuring radiology's value in time saved.

    PubMed

    Lee, Christoph I; Enzmann, Dieter R

    2012-10-01

    Because radiology has historically not measured its added value to patient care and thus not communicated it in easily understood terms to all stakeholders, the specialty must correct this to prepare for the eventual transition from the current fee-for-service payment schedule to new value-based reimbursement systems. Given the increasing risk for marginalization, radiologists need to engage clinicians and managers to map the processes and associated costs of episodes of patient care to identify areas for providing and improving integrated diagnostic information and to measure the value thereof. In such time-driven, activity-based costing practices, radiologists should highlight how proper investments in the information generated by imaging and how radiologists' associated consultative and coordination of services can save greater resources downstream, especially in the nonrenewable resource of physician time, an increasingly scarce health care resource. Using physician time in the most efficient way will be a key element for decreasing health care costs at the aggregate level. Therefore, expressing radiology's contribution in terms of downstream physician time saved is a metric that can be easily understood by all stakeholders. In a conceptual framework centered on value, the specialty of radiology must focus more on its most important product, actionable information, rather than on imaging technologies themselves. Information, unlike imaging technologies, does not depreciate with time but rather increases in value the more it is used.

  10. Measuring radiology's value in time saved.

    PubMed

    Lee, Christoph I; Enzmann, Dieter R

    2012-10-01

    Because radiology has historically not measured its added value to patient care and thus not communicated it in easily understood terms to all stakeholders, the specialty must correct this to prepare for the eventual transition from the current fee-for-service payment schedule to new value-based reimbursement systems. Given the increasing risk for marginalization, radiologists need to engage clinicians and managers to map the processes and associated costs of episodes of patient care to identify areas for providing and improving integrated diagnostic information and to measure the value thereof. In such time-driven, activity-based costing practices, radiologists should highlight how proper investments in the information generated by imaging and how radiologists' associated consultative and coordination of services can save greater resources downstream, especially in the nonrenewable resource of physician time, an increasingly scarce health care resource. Using physician time in the most efficient way will be a key element for decreasing health care costs at the aggregate level. Therefore, expressing radiology's contribution in terms of downstream physician time saved is a metric that can be easily understood by all stakeholders. In a conceptual framework centered on value, the specialty of radiology must focus more on its most important product, actionable information, rather than on imaging technologies themselves. Information, unlike imaging technologies, does not depreciate with time but rather increases in value the more it is used. PMID:23025865

  11. [The traumatized foot--clinical and radiological study].

    PubMed

    Brunner, U H; Blahs, U; Kenn, R W

    1991-03-01

    Thorough examination of the injured foot is the basis of a complete diagnosis and the foundation for successful therapy. Anatomical and biomechanical knowledge is a necessity to achieve this goal. The radiological diagnostic procedures include plain film, digital subtraction angiography, US, CT and MRI. Only the combination of clinical and radiological assessment will lead to optimal results.

  12. A general natural-language text processor for clinical radiology.

    PubMed Central

    Friedman, C; Alderson, P O; Austin, J H; Cimino, J J; Johnson, S B

    1994-01-01

    OBJECTIVE: Development of a general natural-language processor that identifies clinical information in narrative reports and maps that information into a structured representation containing clinical terms. DESIGN: The natural-language processor provides three phases of processing, all of which are driven by different knowledge sources. The first phase performs the parsing. It identifies the structure of the text through use of a grammar that defines semantic patterns and a target form. The second phase, regularization, standardizes the terms in the initial target structure via a compositional mapping of multi-word phrases. The third phase, encoding, maps the terms to a controlled vocabulary. Radiology is the test domain for the processor and the target structure is a formal model for representing clinical information in that domain. MEASUREMENTS: The impression sections of 230 radiology reports were encoded by the processor. Results of an automated query of the resultant database for the occurrences of four diseases were compared with the analysis of a panel of three physicians to determine recall and precision. RESULTS: Without training specific to the four diseases, recall and precision of the system (combined effect of the processor and query generator) were 70% and 87%. Training of the query component increased recall to 85% without changing precision. PMID:7719797

  13. Integrating Preclinical and Clinical Oral Diagnosis and Radiology.

    ERIC Educational Resources Information Center

    Rhodus, Nelson L.; Brand, John W.

    1988-01-01

    A program providing second-year dental students with early experience in direct patient contact in an oral diagnosis/oral radiology clinic was well received by both students and faculty and was found to develop desirable skills and qualities in the students participating. (MSE)

  14. Long-Term Clinical and Radiologic Outcomes of Minimally Invasive Posterior Cervical Foraminotomy

    PubMed Central

    2014-01-01

    Objective To report long-term clinical and radiological outcomes of minimally invasive posterior cervical foraminotomy (MI-PCF) performed in patients with unilateral single-level cervical radiculopathy. Methods Of forty-six patients who underwent MI-PCF for unilateral single-level radiculopathy between 2005 and 2013, 33 patients were included in the study, with a mean follow-up of 32.7 months. Patients were regularly followed for clinical and radiological assessment. Clinical outcome was measured by visual analogue scale (VAS) for the neck/shoulder and arm, and the neck disability index (NDI). Radiological outcome was measured by focal/global angulation and disc height index (DHI). Outcomes after MI-PCF were evaluated as changes of clinical and radiological parameters from the baseline. Mixed effect model with random patients' effect was used to test for differences in the clinical and radiological parameters repeat measures. Results There were no complications and all patients had an uneventful recovery during the early postoperative period. VAS scores for neck/shoulder and arm improved significantly in the early postoperative period (3 months) and were maintained with time (p<0.001). NDI improved significantly post-operatively and tended to decrease gradually during the follow-up period (p<0.001). There were no statistically significant changes in focal and global angulation at follow-up. Percent DHIs of the upper adjacent or operated disc were maintained without significant changes with time. During the follow-up, same site recurrence was not noted and adjacent segment disease requiring additional surgery occurred in two patients (6%) on the contra-lateral side. Conclusion MI-PCF provides long-term pain relief and functional restoration, accompanied by good long-term radiological outcome. PMID:25368765

  15. Angioleiomyoma: a clinical, pathological and radiological review.

    PubMed

    Ramesh, P; Annapureddy, S R; Khan, F; Sutaria, P D

    2004-06-01

    Angioleiomyoma is a benign tumour arising from the vascular smooth muscle (tunica media) and presents commonly between third and fifth decades of life. Although there are sporadic reports about this tumour in the literature, none describes all the information in detail. This review is an attempt to collate all the facts in one concise article. Angioleiomyoma presents as a painful mass in approximately 60% of the cases. One of the distinct clinical feature noted is the increase in size of the swelling with physical activity of the involved part, especially in the hand. It should be considered in the differential diagnosis of painful nodular lesions of the extremity. Pre-operative diagnosis is difficult, but with a high index of suspicion and awareness, it is possible. The use of ultrasound and magnetic resonance imaging should be considered. It causes minimal morbidity and excision is usually curative. Histological examination using smooth muscle Actin stain portraits the smooth muscle bundles clearly. PMID:15311559

  16. Chondrosarcoma in Childhood: The Radiologic and Clinical Conundrum

    PubMed Central

    Mosier, Susan M.; Patel, Tanvi; Strenge, Karen; Mosier, Andrew D.

    2012-01-01

    Less than 10% of chondrosarcomas occur in children. In addition, as little as 0.5% of low-grade chondrosarcomas arise secondarily from benign chondroid lesions. The presence of focal pain is often used to crudely distinguish a chondrosarcoma (which is usually managed with wide surgical excision), from a benign chondroid lesion (which can be followed by clinical exams and imaging surveillance). Given the difficulty of localizing pain in the pediatric population, initial radiology findings and short-interval follow-up, both imaging and clinical, are critical to accurately differentiate a chondrosarcoma from a benign chondroid lesion. To our knowledge, no case in the literature discusses a chondrosarcoma possibly arising secondarily from an enchondroma in a pediatric patient. We present a clinicopathologic and radiology review of conventional chondrosarcomas. We also attempt to further the understanding of how to manage a chondroid lesion in the pediatric patient with only vague or bilateral complaints of pain. PMID:23365701

  17. Chondrosarcoma in childhood: the radiologic and clinical conundrum.

    PubMed

    Mosier, Susan M; Patel, Tanvi; Strenge, Karen; Mosier, Andrew D

    2012-12-01

    Less than 10% of chondrosarcomas occur in children. In addition, as little as 0.5% of low-grade chondrosarcomas arise secondarily from benign chondroid lesions. The presence of focal pain is often used to crudely distinguish a chondrosarcoma (which is usually managed with wide surgical excision), from a benign chondroid lesion (which can be followed by clinical exams and imaging surveillance). Given the difficulty of localizing pain in the pediatric population, initial radiology findings and short-interval follow-up, both imaging and clinical, are critical to accurately differentiate a chondrosarcoma from a benign chondroid lesion. To our knowledge, no case in the literature discusses a chondrosarcoma possibly arising secondarily from an enchondroma in a pediatric patient. We present a clinicopathologic and radiology review of conventional chondrosarcomas. We also attempt to further the understanding of how to manage a chondroid lesion in the pediatric patient with only vague or bilateral complaints of pain. PMID:23365701

  18. Subcortical arteriosclerotic encephalopathy: a clinical and radiological investigation.

    PubMed Central

    Loizou, L A; Kendall, B E; Marshall, J

    1981-01-01

    Subcortical arteriosclerotic encephalopathy (Binswanger's type) was diagnosed in a group of patients with hypertension or arteriosclerosis, who showed acute and subacute neurological deficits, dementia, reduced cerebral blood flow, and white matter low attenuation with mild atrophy and infarcts as the predominant CT scan features. This set of clinical and radiological criteria could be used to make the diagnosis in life, as confirmed neuropathologically in one patient. Images PMID:7241156

  19. Intestinal tuberculosis versus crohn's disease: Clinical and radiological recommendations.

    PubMed

    Sharma, Raju; Madhusudhan, Kumble S; Ahuja, Vineet

    2016-01-01

    Intestinal tuberculosis is a common clinical problem in India. The clinical features of this disease are nonspecific and can be very similar to Crohn's disease. Radiological evaluation of the small bowel has undergone a paradigm shift in the last decade. This long tubular organ that has traditionally been difficult to evaluate can now be well-visualized by some innovative imaging and endoscopic techniques. This article highlights the state-of-the-art evaluation of ulceroconstrictive diseases of the bowel and provides recommendations for the differentiation of intestinal tuberculosis from Crohn's disease. PMID:27413261

  20. Intestinal tuberculosis versus crohn's disease: Clinical and radiological recommendations

    PubMed Central

    Sharma, Raju; Madhusudhan, Kumble S; Ahuja, Vineet

    2016-01-01

    Intestinal tuberculosis is a common clinical problem in India. The clinical features of this disease are nonspecific and can be very similar to Crohn's disease. Radiological evaluation of the small bowel has undergone a paradigm shift in the last decade. This long tubular organ that has traditionally been difficult to evaluate can now be well-visualized by some innovative imaging and endoscopic techniques. This article highlights the state-of-the-art evaluation of ulceroconstrictive diseases of the bowel and provides recommendations for the differentiation of intestinal tuberculosis from Crohn's disease. PMID:27413261

  1. Radiological dosimetry measurements in Costa Rica

    NASA Astrophysics Data System (ADS)

    León, M.; Santos, F.

    2016-07-01

    The main cause of human exposure to artificial radiation corresponds to medical applications, so it is essential to reduce the dose to patients, workers and consequently the entire population [1]. Although there is no dose limit for patients, is necessary to reduce it to a minimum possible while still getting all the necessary diagnostic information, taking economic and social factors into account [2]. Based on this proposal, agencies such as the International Atomic Energy Agency has been dedicated to providing guidelines levels, whose function is to serve as standards for the optimization of the medical exposure [3]. This research was created as a preliminary survey with the claim of eventually determine the guidance levels in Costa Rica for three different studies of general radiology: Lumbar Spine-AP, Chest - PA and Thoracic Spine - AP (for screens with speeds of 400 and 800), and cranio-caudal study in mammography, applied to Costa Rica's adult population, perform properly in the institutions of Caja Costarricense del Seguro Social (CCSS).

  2. Radiological Disaster Simulators for Field and Aerial Measurements

    SciTech Connect

    H. W. Clark, Jr

    2002-11-01

    Simulators have been developed to dramatically improve the fidelity of play for field monitors and aircraft participating in radiological disaster drills and exercises. Simulated radiological measurements for the current Global Positioning System (GPS) location are derived from realistic models of radiological consequences for accidents and malicious acts. The aerial version outputs analog pulses corresponding to the signal that would be produced by various NaI (Tl) detectors at that location. The field monitor version reports the reading for any make/model of survey instrument selected. Position simulation modes are included in the aerial and field versions. The aerial version can generate a flight path based on input parameters or import an externally generated sequence of latitude and longitude coordinates. The field version utilizes a map-based point and click/drag interface to generate individual or a sequence of evenly spaced instrument measurements.

  3. [Modern clinical and radiological approach to diagnostics of odontogenic sinusitis].

    PubMed

    Khomutova, E Yu; Ignat'ev, Yu T; Demyanchuk, A N; Demyanchuk, A B

    2015-01-01

    Inflammatory diseases of the maxillary sinuses affect up to 70% of the adult population. Odontogenic maxillary sinusitis represents 13-86% of the inflammatory processes of maxillofacial area, with the incidence range being explained rather by varying diagnosis criteria than the true incidence difference of odontogenic lesions. The aim of the study was to summarize the clinical and radiological characteristics of odontogenic sinusitis according to patients records in the Department of Maxillofacial Surgery of Omsk Clinical Hospital No11 and the oral surgery department of BUZ GKSP No1 in 2009-2014. A total of 948 records of patient (aged 17 to 68 years) with maxillary sinusitis were identified. X-ray examinations were performed by CT PISASSO TRIO ("KoYo", South Korea) and MSCT Brillians 6 and Brillians 64 ((Philips HealthCare), Netherlands). Images were obtained in axial projection with slice thickness of 0.2-0.6 mm with multiplanar reconstructions (MPR) in a variety of direct and oblique projections. Altogether 664 patients were diagnosed with foreign bodies in the maxillary sinuses (filling material in 569 cases, roots or root fragments? implants, rubber drains, fragments of endodontic instruments in 95 cases). In 284 persons odontogenic cysts were found. Almost every fifth case was complicated by mycotic infection. Analysis of the results showed that only a multidisciplinary approach including dentists, maxillofacial surgeons, otolaryngologists and radiologists, as well as dental volumetric tomography or multislice CT can ensure the correct clinical and radiological approaches to determine the tactics of treatment in patients with sinusitis, reduce the incidence of relapses and chronic inflammatory processes in the maxillary sinuses.

  4. [Anterior cervical fusion with tantalum interbody implants. Clinical and radiological results in a prospective study].

    PubMed

    Vicario, C; Lopez-Oliva, F; Sánchez-Lorente, T; Zimmermann, M; Asenjo-Siguero, J J; Ladero, F; Ibarzábal, A

    2006-04-01

    Anterior cervical discectomy and interbody fusion (ACDF) is a widely accepted surgical technique in the treatment of cervical disc disease. Tantalum cages have been recently introduced in spine surgery for interbody fusion because of the advantages of their mechanical properties. We present the results of a prospective clinical and radiological study on 24 consecutive patients who underwent an ACDF with tantalum cages. Clinical evaluation was assessed preoperatively and after surgery by a questionnaire that included a Visual Analogic Scale (VAS) of neck and arm pain, the Oswestry Disability Index and the Zung Depression Scale. Results were classified by Odom's criteria. Radiological evaluation included flexion-extension X-rays, and changes in distance between spinous processes and Cobb angle were measured. Postoperatively patients were reviewed 3 and 12 months after surgery. A statistical significative improvement in all clinical data was reported. According to Odom's criteria in 75% of patients the results were considered like excellent or good. Only one case of radiological and clinical pseudoarthrosis was confirmed. No significative differences were reported 3 and 12 months after surgery. Tantalum cages are a very promising and usefull alternative among implants available for ACDF. Compatibility with MRI postoperative studies and the unnecessariness of autograft are some of their advantages. PMID:16721480

  5. [Anterior cervical fusion with tantalum interbody implants. Clinical and radiological results in a prospective study].

    PubMed

    Vicario, C; Lopez-Oliva, F; Sánchez-Lorente, T; Zimmermann, M; Asenjo-Siguero, J J; Ladero, F; Ibarzábal, A

    2006-04-01

    Anterior cervical discectomy and interbody fusion (ACDF) is a widely accepted surgical technique in the treatment of cervical disc disease. Tantalum cages have been recently introduced in spine surgery for interbody fusion because of the advantages of their mechanical properties. We present the results of a prospective clinical and radiological study on 24 consecutive patients who underwent an ACDF with tantalum cages. Clinical evaluation was assessed preoperatively and after surgery by a questionnaire that included a Visual Analogic Scale (VAS) of neck and arm pain, the Oswestry Disability Index and the Zung Depression Scale. Results were classified by Odom's criteria. Radiological evaluation included flexion-extension X-rays, and changes in distance between spinous processes and Cobb angle were measured. Postoperatively patients were reviewed 3 and 12 months after surgery. A statistical significative improvement in all clinical data was reported. According to Odom's criteria in 75% of patients the results were considered like excellent or good. Only one case of radiological and clinical pseudoarthrosis was confirmed. No significative differences were reported 3 and 12 months after surgery. Tantalum cages are a very promising and usefull alternative among implants available for ACDF. Compatibility with MRI postoperative studies and the unnecessariness of autograft are some of their advantages.

  6. Clinical and Radiologic Disease in Smokers With Normal Spirometry

    PubMed Central

    Regan, Elizabeth A.; Lynch, David A.; Curran-Everett, Douglas; Curtis, Jeffrey L.; Austin, John H. M.; Grenier, Philippe A.; Kauczor, Hans-Ulrich; Bailey, William C.; DeMeo, Dawn L.; Casaburi, Richard H.; Friedman, Paul; Van Beek, Edwin J. R.; Hokanson, John E.; Bowler, Russell P.; Beaty, Terri H.; Washko, George R.; Han, MeiLan K.; Kim, Victor; Kim, Song Soo; Yagihashi, Kunihiro; Washington, Lacey; McEvoy, Charlene E.; Tanner, Clint; Mannino, David M.; Make, Barry J.; Silverman, Edwin K.; Crapo, James D.

    2015-01-01

    IMPORTANCE Airflow obstruction on spirometry is universally used to define chronic obstructive pulmonary disease (COPD), and current or former smokers without airflow obstruction may assume that they are disease free. OBJECTIVE To identify clinical and radiologic evidence of smoking-related disease in a cohort of current and former smokers who did not meet spirometric criteria for COPD, for whom we adopted the discarded label of Global Initiative for Obstructive Lung Disease (GOLD) 0. DESIGN, SETTING, AND PARTICIPANTS Individuals from the Genetic Epidemiology of COPD (COPDGene) cross-sectional observational study completed spirometry, chest computed tomography (CT) scans, a 6-minute walk, and questionnaires. Participants were recruited from local communities at 21 sites across the United States. The GOLD 0 group (n = 4388) (ratio of forced expiratory volume in the first second of expiration [FEV1] to forced vital capacity >0.7 and FEV1 ≥80% predicted) from the COPDGene study was compared with a GOLD 1 group (n = 794), COPD groups (n = 3690), and a group of never smokers (n = 108). Recruitment began in January 2008 and ended in July 2011. MAIN OUTCOMES AND MEASURES Physical function impairments, respiratory symptoms, CT abnormalities, use of respiratory medications, and reduced respiratory-specific quality of life. RESULTS One or more respiratory-related impairments were found in 54.1% (2375 of 4388) of the GOLD 0 group. The GOLD 0 group had worse quality of life (mean [SD] St George’s Respiratory Questionnaire total score, 17.0 [18.0] vs 3.8 [6.8] for the never smokers; P < .001) and a lower 6-minute walk distance, and 42.3% (127 of 300) of the GOLD 0 group had CT evidence of emphysema or airway thickening. The FEV1 percent predicted distribution and mean for the GOLD 0 group were lower but still within the normal range for the population. Current smoking was associated with more respiratory symptoms, but former smokers had greater emphysema and gas trapping

  7. Hypersensitivity pneumonitis: a historical, clinical, and radiologic review.

    PubMed

    Hirschmann, Jan V; Pipavath, Sudhakar N J; Godwin, J David

    2009-11-01

    Most cases of hypersensitivity pneumonitis develop only after many years of inhaling allergens, which include microbes, animal or plant proteins, and certain chemicals that form haptens. The initial clinical presentation is either episodes of acute illness with dyspnea and prominent constitutional symptoms, such as fever, or an insidious onset of dyspnea, coughing, and weight loss, sometimes with superimposed acute episodes. The histopathologic process consists of chronic inflammation of the bronchi and peribronchiolar tissue, often with poorly defined granulomas and giant cells in the interstitium or alveoli. Fibrosis and emphysema may develop. The radiologic findings include diffuse ground-glass opacification, centrilobular ground-glass opacities, air trapping, fibrosis, lung cysts, and emphysema. The histologic and radiologic features in some cases may resemble those of usual interstitial pneumonia or nonspecific interstitial pneumonia. The diagnosis usually rests on a variable combination of findings from history, serology, radiography, lung biopsy, and bronchoalveolar lavage, which characteristically reveals a lymphocyte content of more than 30%, often with an increased CD4-to-CD8 ratio of T cells. Treatment includes avoiding the allergen, if possible, and, in severe cases, systemic corticosteroids. The long-term prognosis is usually good, but some patients develop severe respiratory insufficiency, and a few die of the disease.

  8. Clinical Experience With A PACS Module In Pediatric Radiology: Clinical Viewpoint

    NASA Astrophysics Data System (ADS)

    Kangarloo, H.; Boechat, M. I.; Dietrich, R.; Hall, T.; Taira, R. K.; Mankovich, N. J.; Huang, H. K.

    1988-06-01

    A PACS module for Pediatric Radiology began routine clinical operation in March 1987. The system thus far has been used to conduct daily X-ray rounds as well as for fast patient reviews during all hours of the day. This paper describes the clinical operation of this system including patient registration, image acquisition, image management, and patient case reviews. A PACS system operator is responsible for the daily mainenance of the system. These responsibilities are outlined.

  9. [Radiologic and clinical aspects of osteoarticular amyloidosis caused by dialysis].

    PubMed

    Baldrati, L; Rocchi, A; Balbi, B; Bonsanto, R; Mughetti, M; Pasini, A; Feletti, C; Capponcini, C; Docci, D

    1991-06-01

    Many long-term (greater than 60 months) hemodialysis patients develop a severe osteoarticular disease, called "dialysis arthropathy", which is characterized by the deposition in bone and synovia of a new type of amyloid made mainly of beta 2-microglobulin. In the present study, 31 patients (17 males, 14 females; age 54.1 +/- 13 years), undergoing chronic hemodialysis for 60-125 months, were examined for dialysis arthropathy by means of clinics and of radiological investigations (conventional radiography and computed tomography). Sixteen patients (51.6%) had radiographic evidence of dialysis arthropathy: geodes (shoulders, 12 cases; wrists, 11; hips, 2; knees, 2) and/or destructive arthropathies (cervical spine, 13 cases, dorsolumbar spine, 2; hands, 2; hips, 1). Within 24 months, these lesions were found to progress slowly in the majority of cases. In the diagnostic process, CT should be employed in the study of spine, shoulders and hips when the lesions have not been sufficiently demonstrated by conventional radiography in the presence of evident clinical signs. Patients with dialysis arthropathy had undergone dialysis for longer periods than those without it (p less than 0.005) and showed a significantly higher incidence of both carpal tunnel syndrome (p less than 0.0005) and shoulder pain (p less than 0.005). Our findings confirm the high incidence and clinical importance of dialysis arthropathy in long-term hemodialysis patients and the value of diagnostic imaging in screening such patients for those lesions.

  10. The Clinical and Radiological Effect of Abnormal Axis after Cervical Arthroplasty

    PubMed Central

    Jang, Hyun Jun; Oh, Chang Hyun; Kim, Ji Yong; Park, Hyeong Chun; Kim, Yoon Hyuk

    2015-01-01

    Objective The clinical outcomes according to the radiological results after cervical total disc replacement (TDR) are not well established. Here, the authors reviewed the clinical results according to the asymmetry in radiographs. Methods This retrospective analysis included patients after TDR (Mobi-C® disc) with at least 12 months follow up, and the clinical and radiological data were obtained preoperatively and postoperatively for 12 months. Clinical outcome measures numerical rating scale (NRS) score for neck pain, visual analog scale (VAS) for arm pain, and the Oswestry disability index (ODI) value. The asymmetries of TDRs were evaluated on the anterior-posterior (AP) and the lateral radiographs, and the radiographic adjacent segment degenerations were evaluated for 12 months. Results A total of 24 patients (one level cervical TDR; 10 male and 14 female; aged 41.50±8.35 years) were included in this study. The clinical results including NRS for neck pain, VAS for arm pain, and ODIs were similar between the normal and asymmetrized TDRs in AP and lateral radiographs. The radiographic adjacent segment degenerations were significantly increased in deviated TDRs (AP>10 mm asymmetry and lateral>10 mm asymmetry). Conclusion Asymmetrical location of TDR is not related to the clinical outcomes, but related to the risk of radiographic adjacent disc segment degeneration. PMID:26539265

  11. Neutron Energy Measurements in Radiological Emergency Response Applications

    SciTech Connect

    Sanjoy Mukhopadhyay, Paul Guss, Michael Hornish, Scott Wilde, Tom Stampahar, Michael Reed

    2009-04-30

    We present significant results in recent advances in the determination of neutron energy. Neutron energy measurements are a small but very significant part of radiological emergency response applications. Mission critical information can be obtained by analyzing the neutron energy given off from radioactive materials. In the case of searching for special nuclear materials, neutron energy information from an unknown source can be of paramount importance.

  12. [Radiologic medical desktop conferences--clinical evaluation of the KAMEDIN teleradiology system in routine practice of a radiologic institute].

    PubMed

    Bolte, R; Lehmann, K J; Walz, M; Loose, R; Lütgemeier, J; Seibert, F; Busch, C; Schinkmann, M; Georgi, M

    1996-07-01

    KAMEDIN is a teleradiology project of "Deutsche Telekom". ISDN based image transfer, visualisation and online-presentation of digital radiological images is performed. In this study the suitability of the KAMEDIN-system has been tested in a clinical environment. The software has been adapted to the requirements of radiological image visualisation. During 6 months over 50 conferences took place with an average of 36 CT-slices per patient. The amount of time was approximately 10 min for conference preparation, 20 min for image transfer and 8 min for conferencing. Software problems occurred and were solved. Image quality on the monitor as well as online presentation including "simultaneous cursors" showed high performance and achieved high acceptance by the clinicians. Thus KAMEDIN is a useful teleradiology system, especially if the system is adapted to the requirements of radiology departments. PMID:8924455

  13. The Relationship between Method of Clinical Instruction in Radiography and Scores on the American Registry of Radiologic Technologists Certification Examination.

    ERIC Educational Resources Information Center

    Dowd, Steven B.

    An examination was made of the relationship between clinical grade based on simulation and a subsequent outcome measurement, the national certification examination in radiography. Although the new "Essentials" developed by the Joint Review Committee in Education in Radiologic Technology discouraged use of simulation, the method had worked well for…

  14. Citizenship in radiology: defining a concept and proposing its measure.

    PubMed

    Lee, Christoph I; Herrington, William T; Donner, E Michael; Bluth, Edward I

    2013-06-01

    Merely suggesting that radiologists answer the call to bolster and secure the future of their own specialty has not resulted in increased activism. Therefore, the ACR Commission on Human Resources has developed a definition for the concept of citizenship in radiology and explicit descriptions of the activities associated with it. Furthermore, the authors introduce a methodology for the measurement and valuation of individual radiologists' contributions to group practices and to the specialty as a whole. These measures can in turn be used to promote, acknowledge, recognize, and incentivize citizenship activity among radiologists at the local, regional, and national levels. PMID:23583084

  15. Cerebellar disorders: clinical/radiologic findings and modern imaging tools.

    PubMed

    Manto, Mario; Habas, Christophe

    2016-01-01

    Cerebellar disorders, also called cerebellar ataxias, comprise a large group of sporadic and genetic diseases. Their core clinical features include impaired control of coordination and gait, as well as cognitive/behavioral deficits usually not detectable by a standard neurologic examination and therefore often overlooked. Two forms of cognitive/behavioral syndromes are now well identified: (1) the cerebellar cognitive affective syndrome, which combines an impairment of executive functions, including planning and working memory, deficits in visuospatial skills, linguistic deficiencies such as agrammatism, and inappropriate behavior; and (2) the posterior fossa syndrome, a very acute form of cerebellar cognitive affective syndrome occurring essentially in children. Sporadic ataxias include stroke, toxic causes, immune ataxias, infectious/parainfectious ataxias, traumatic causes, neoplasias and paraneoplastic syndromes, endocrine disorders affecting the cerebellum, and the so-called "degenerative ataxias" (multiple system atrophy, and sporadic adult-onset ataxias). Genetic ataxias include mainly four groups of disorders: autosomal-recessive cerebellar ataxias, autosomal-dominant ataxias (spinocerebellar ataxias and episodic ataxias), mitochondrial disorders, and X-linked ataxias. In addition to biochemical studies and genetic tests, brain imaging techniques are a cornerstone for the diagnosis, clinicoanatomic correlations, and follow-up of cerebellar ataxias. Modern radiologic tools to assess cerebellar ataxias include: functional imaging studies, magnetic resonance spectroscopy, volumetric studies, and tractography. These complementary methods provide a multimodal appreciation of the whole long-range cerebellar network functioning, and allow the extraction of potential biomarkers for prognosis and rating level of recovery after treatment. PMID:27432679

  16. Abdominal aortic aneurysm and histological, clinical, radiological correlation.

    PubMed

    Rodella, Luigi Fabrizio; Rezzani, Rita; Bonomini, Francesca; Peroni, Michele; Cocchi, Marco Angelo; Hirtler, Lena; Bonardelli, Stefano

    2016-04-01

    To date, the pathogenesis of abdominal aortic aneurism (AAA) still remains unclear. As such, the aim of this study was to evaluate changes of the aortic structure during AAA. We analysed the microscopic frame of vessels sections, starting from the primum movens leading to abnormal dilatation. AAA samples were collected and processed through various staining methods (Verhoeff-Van Gieson, Masson Goldner, Sirius Red). Subsequently, the vessel morphology and collagenic web of the tunica media and adventitia were determined and the amount of type I and type III collagen was measured. We also applied immune-histochemistry markers for CD34 and PGP 9.5 in order to identify vascular and nerve structures in the aorta. Immune-positivity quantification was used to calculate the percentage of the stained area. We found increasing deposition of type I collagen and reduced type III collagen in both tunica media and adventitia of AAA. The total amount of vasa vasorum, marked with CD34, and nerva vasorum, marked with PGP 9.5, was also higher in AAA samples. Cardiovascular risk factors (blood pressure, dyslipidemia, cigarette smoking) and radiological data (maximum aneurism diameter, intra-luminal thrombus, aortic wall calcification) increased these changes. These results suggest that the tunica adventitia may have a central role in the pathogenesis of AAA as clearly there are major changes characterized by rooted inflammatory infiltration. The presence of immune components could explain these modifications within the framework of the aorta. PMID:26858185

  17. Clinical and topographical range of callosal infarction: a clinical and radiological correlation study.

    PubMed Central

    Giroud, M; Dumas, R

    1995-01-01

    A prospective clinical and radiological correlation study was performed to determine the frequency, and the clinical and radiological features of callosal infarction. From 1 January 1993 to the end of December 1993 282 cases of cerebral infarction seen in the Neurology service of the University Hospital of Dijon were studied prospectively. Eight cases with callosal ischaemic lesions were identified by CT and MRI. A callosal disconnection syndrome occurred in only five of eight patients, related to a single, large infarct or several infarctions in the anterior part of the corpus callosum. Clinical features were characterised by left ideomotor apraxia, construction apraxia, and left agraphia in all five cases. Alien hand was noted in only two cases. There were gait disorders in three cases with MRI features of multiple lacunes in a large part of the corpus callosum, and also the subcortical areas of both hemispheres. It is emphasised that callosal infarctions are not rare and that they contribute to the clinical features of strokes. As well as the classic incomplete callosal disconnection syndrome, these callosal ischaemic lesions may induce non-specific gait disorders. Images PMID:7673948

  18. Clinical routine operation of a filmless radiology department: three years experience

    NASA Astrophysics Data System (ADS)

    Mosser, Hans M.; Paertan, Gerald; Hruby, Walter

    1995-05-01

    This paper communicates the operational implementation of filmless digital radiology in clinical routine, its feasibility and its effect on the radiology profession, based on the three years clinical experience from the filmless digital radiology department of the Danube Hospital, a major teaching hospital in Vienna, Austria, with currently 850 acute-care beds. Since April 1992 all radiological modalities are reported from the monitors of 16 reporting consoles in the radiology department. Images and reports are distributed by the hospital-wide network (Sienet, Siemens Medical Systems, Erlangen), and can be viewed on 60 display consoles throughout the hospital. Filmless radiology primarily is an efficient hospital-wide infrastructure to deliver radiological services along with other medical information, providing safe and fast access to this information anytime and anywhere, necessary for the conduct of the diagnostic and therapeutic task of patient care. In a comparative study of the Danube Hospital with the film based Rudolfstiftung Hospital in Vienna, we found a significant decrease of the mean patient length of hospital stay (1.99 to 3.72 days) that partially might be attributed to the implementation of filmless radiology.

  19. [Key aspects in interpreting clinical trials in radiology].

    PubMed

    Díaz Gómez, L; García Villar, C; Seguro Fernández, Á

    2015-01-01

    A clinical trial is an experimental study to evaluate the efficacy and safety of a treatment or diagnostic technique in human beings. To ensure the methodological quality of a clinical trial and the validity of its results, various checklists have been elaborated to identify biases that could invalidate its conclusions. This article focuses on the points we need to consider in the critical evaluation of a clinical trial. We can usually find this information in the "materials and methods" and "results" sections of articles. Randomization, follow-up (or analysis of losses), blinding, and equivalence between groups (apart from the intervention itself) are some key aspects related to design. In the "results" section, we need to consider what measures of clinical efficacy were used (relative risk, odds ratio, or number needed to treat, among others) and the precision of the results (confidence intervals). Once we have confirmed that the clinical trial fulfills these criteria, we need to determine whether the results can be applied in our environment and whether the benefits obtained justify the risks and costs involved.

  20. Clinical radiology of the spine and spinal cord

    SciTech Connect

    Banna, M.

    1985-01-01

    This book is a source of information about aspects of radiology of the spine and spinal column. It presents coverage of both normal and abnormal conditions. Contents: Spinal fractures and dislocations. Degenerative diseases of the spine. Gross anatomy of the spinal cord and meninges. Intraspinal mass lesions. Spinal dysraphism. Congenital anomalies. Tumors of the vertebral column, and more.

  1. Joint Probability Models of Radiology Images and Clinical Annotations

    ERIC Educational Resources Information Center

    Arnold, Corey Wells

    2009-01-01

    Radiology data, in the form of images and reports, is growing at a high rate due to the introduction of new imaging modalities, new uses of existing modalities, and the growing importance of objective image information in the diagnosis and treatment of patients. This increase has resulted in an enormous set of image data that is richly annotated…

  2. Natural Language Processing Technologies in Radiology Research and Clinical Applications.

    PubMed

    Cai, Tianrun; Giannopoulos, Andreas A; Yu, Sheng; Kelil, Tatiana; Ripley, Beth; Kumamaru, Kanako K; Rybicki, Frank J; Mitsouras, Dimitrios

    2016-01-01

    The migration of imaging reports to electronic medical record systems holds great potential in terms of advancing radiology research and practice by leveraging the large volume of data continuously being updated, integrated, and shared. However, there are significant challenges as well, largely due to the heterogeneity of how these data are formatted. Indeed, although there is movement toward structured reporting in radiology (ie, hierarchically itemized reporting with use of standardized terminology), the majority of radiology reports remain unstructured and use free-form language. To effectively "mine" these large datasets for hypothesis testing, a robust strategy for extracting the necessary information is needed. Manual extraction of information is a time-consuming and often unmanageable task. "Intelligent" search engines that instead rely on natural language processing (NLP), a computer-based approach to analyzing free-form text or speech, can be used to automate this data mining task. The overall goal of NLP is to translate natural human language into a structured format (ie, a fixed collection of elements), each with a standardized set of choices for its value, that is easily manipulated by computer programs to (among other things) order into subcategories or query for the presence or absence of a finding. The authors review the fundamentals of NLP and describe various techniques that constitute NLP in radiology, along with some key applications. PMID:26761536

  3. Patient dose measurements in diagnostic radiology procedures in Montenegro.

    PubMed

    Milatović, Aleksandra; Ciraj-Bjelac, Olivera; Ivanović, Sonja; Jovanović, Slobodan; Spasić-Jokić, Vesna

    2012-05-01

    It was the aim of the study presented here to estimate for the first time patient dose levels in conventional diagnostic radiology in Montenegro. Measurements of patient dose in terms of entrance surface air kerma (ESAK) and kerma-area product (KAP) were performed on at least 10 patients for each examination type, in each of five randomly selected health institutions in Montenegro, so that a total of 872 patients for 16 different examination categories were included in the survey (817 patients for 1049 radiographies and 55 fluoroscopy patients). Exposure settings and individual data were recorded for each patient. Mean, median and third quartile values ESAK of patient doses are reported. The estimated mean ESAK values obtained are as follows: 4.7 mGy for pelvis anteroposterior (AP), 4.5 mGy for lumbar spine AP, 7.8 mGy for lumbar spine lateral (LAT), 3.1 mGy for thoracic spine AP and 4.3 mGy for thoracic spine LAT. When compared with the European diagnostic reference values, the mean ESAK for all studied examination types are found to be below the reference levels, except in chest radiography. Mean ESAK values for chest radiography are 0.9 mGy for posteroanterior (PA) projection and 2.0 mGy for LAT. The results exhibit a wide range of variation. For fluoroscopy examinations, the total KAP was measured. The mean KAP value per procedure for barium meal is found to be 22 Gy cm(2), 41 Gy cm(2) for barium enema and 19 Gy cm(2) for intravenous urography. Broad dose ranges for the same types of examinations indicate the necessity of applying practice optimisation in diagnostic radiology and establishment of national diagnostic reference levels.

  4. The General Electric-Association of University Radiologists Radiology Research Academic Fellowship (GERRAF). An industry-academic collaboration to improve clinical research in radiology.

    PubMed

    Hillman, B J; Fryback, D G; Holden, R W; McNeil, B J; Molitor, R M; Moss, A A; Peck, P V; Putman, C E; Thompson, W M

    1993-05-01

    The association of GE Medical Systems and the AUR represents a unique collaboration between academic radiology and industry that bears important potential for elevating the quality of clinical research in radiology and developing a cadre of high-quality radiologist researchers for the future. The establishment of the GERRAF is especially timely given the new imperatives of the rapidly changing health care environment, with its emphasis on expenditure reduction. The ultimate goals of GERRAF are to develop research leaders for radiology that will provide guidance for appropriate clinical practice, better train future researchers, and secure the role of radiologists in caring for patients.

  5. Patellofemoral pain syndrome: validity of clinical and radiological features.

    PubMed

    Haim, Amir; Yaniv, Moshe; Dekel, Samuel; Amir, Hagay

    2006-10-01

    Data regarding validity of clinical and radiographic findings in diagnosing patellofemoral pain syndrome are inconclusive. We prospectively assessed how sensitive and specific key patellofemoral physical examination tests are, and evaluated the prevalence of physical examination and radiographic findings. Sixty-one infantry soldiers with patellofemoral pain syndrome and 25 control subjects were evaluated. The sensitivity of the patellar tilt, active instability, patella alta, and apprehension tests was low (less than 50%); specificity ranged between 72% and 100%. Although the prevalence of positive patellar tilt and active instability tests was significantly greater in subjects with patellofemoral pain syndrome, there were no significant differences between the groups in the results of the other two tests. Soldiers with patellofemoral pain syndrome presented with increased quadriceps angle, lateral and medial retinacular tenderness, patellofemoral crepitation, squinting patella, and reduced mobility of the patella. There were no differences between the groups in the prevalence of lower limb and foot posture alignment and knee effusion. Plain radiography showed increased patellar subluxation in soldiers with patellofemoral pain syndrome. Other radiographic measures (sulcus angle, Laurin angle, Merchant angle, and Insall-Salvati index) were similar in both groups. We provide evidence regarding the validity of clinical and radiographic features commonly used for diagnosing patellofemoral pain syndrome. Physical examinations were more useful than plain radiography. PMID:16788411

  6. Extracting numeric measurements and temporal coordinates from Japanese radiological reports

    NASA Astrophysics Data System (ADS)

    Imai, Takeshi; Onogi, Yuzo

    2004-04-01

    Medical records are written mainly, in natural language. The focus of this study is narrative radiological reports written in natural Japanese. These reports cannot be used for advanced retrieval, data mining, and so on, unless they are stored, using a structured format such as DICOM-SR. The goal is to structure narrative reports progressively, using natural language processing (NLP). Structure has many different levels, for example, DICOM-SR has three established levels -- basic text, enhanced and comprehensive. At the enhanced level, it is necessary to use numerical measurements and spatial & temporal coordinates. In this study, the wording used in the reports was first standardized, dictionaries were organized, and morphological analysis performed. Next, numerical measurements and temporal coordinates were extracted, and the objects to which they referred, analyzed. 10,000 CT and MR reports were separated into 82,122 sentences, and 34,269 of the 36,444 numerical descriptions were tagged. Periods, slashes, hyphens, and parentheses are ambiguously used in the description of enumerated lists, dates, image numbers, and anatomical names, as well as at the end of sentences; to resolve this ambiguity, descriptions were processed, according to the order -- date, size, unit, enumerated list, and abbreviation -- then, the tagged reports were separated into sentences.

  7. Clinical compliance of viewing conditions in radiology reporting environments against current guidelines and standards

    NASA Astrophysics Data System (ADS)

    Daly, S.; Rainford, L.; Butler, M. L.

    2014-03-01

    Several studies have demonstrated the importance of environmental conditions in the radiology reporting environment, with many indicating that incorrect parameters could lead to error and misinterpretation. Literature is available with recommendations as to the levels that should be achieved in clinical practice, but evidence of adherence to these guidelines in radiology reporting environments is absent. This study audited the reporting environments of four teleradiologist and eight hospital based radiology reporting areas. This audit aimed to quantify adherence to guidelines and identify differences in the locations with respect to layout and design, monitor distance and angle as well as the ambient factors of the reporting environments. In line with international recommendations, an audit tool was designed to enquire in relation to the layout and design of reporting environments, monitor angle and distances used by radiologists when reporting, as well as the ambient factors such as noise, light and temperature. The review of conditions were carried out by the same independent auditor for consistency. The results obtained were compared against international standards and current research. Each radiology environment was given an overall compliance score to establish whether or not their environments were in line with recommended guidelines. Poor compliance to international recommendations and standards among radiology reporting environments was identified. Teleradiology reporting environments demonstrated greater compliance than hospital environments. The findings of this study identified a need for greater awareness of environmental and perceptual issues in the clinical setting. Further work involving a larger number of clinical centres is recommended.

  8. Radiologic and Clinical Bronchiectasis Associated with Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Moua, Teng; Zand, Ladan; Hartman, Robert P.; Hartman, Thomas E.; Qin, Dingxin; Peikert, Tobias; Qian, Qi

    2014-01-01

    Background Polycystin 1 and 2, the protein abnormalities associated with autosomal dominant polycystic kidney disease (ADPKD), are also found in airway cilia and smooth muscle cells. There is evidence of increased radiologic bronchiectasis associated with ADPKD, though the clinical and functional implications of this association are unknown. We hypothesized an increased prevalence of both radiologic and clinical bronchiectasis is associated with APDKD as compared to non-ADPKD chronic kidney disease (CKD) controls. Materials and Methods A retrospective case-control study was performed at our institution involving consecutive ADPKD and non-ADPKD chronic kidney disease (CKD) patients seen over a 13 year period with both chest CT and PFT. CTs were independently reviewed by two blinded thoracic radiologists. Manually collected clinical data included symptoms, smoker status, transplant history, and PFT findings. Results Ninety-two ADPKD and 95 non-ADPKD CKD control patients were compared. Increased prevalence of radiologic bronchiectasis, predominantly mild lower lobe disease, was found in ADPKD patients compared to CKD control (19 vs. 9%, P = 0.032, OR 2.49 (CI 1.1–5.8)). After adjustment for covariates, ADPKD was associated with increased risk of radiologic bronchiectasis (OR 2.78 (CI 1.16–7.12)). Symptomatic bronchiectasis occurred in approximately a third of ADPKD patients with radiologic disease. Smoking was associated with increased radiologic bronchiectasis in ADPKD patients (OR 3.59, CI 1.23–12.1). Conclusions Radiological bronchiectasis is increased in patients with ADPKD particularly those with smoking history as compared to non-ADPKD CKD controls. A third of such patients have symptomatic disease. Bronchiectasis should be considered in the differential in ADPKD patients with respiratory symptoms and smoking history. PMID:24747723

  9. Biomimetic hydroxyapatite used in the treatment of periodontal intrabony pockets: clinical and radiological analysis

    PubMed Central

    Figliuzzi, Michele Mario; Giudice, Amerigo; Pileggi, Settimia; Scordamaglia, Francesco; Marrelli, Massimo; Tatullo, Marco; Fortunato, Leonzio

    2016-01-01

    Summary Aim Hydroxyapatite (PA) has a chemical composition and physical structure very similar to natural bone and therefore it has been considered to be the ideal biomaterial able to ensure a biomimetic scaffold to use in bone tissue engineering. The aim of this study is to clinically test hydroxyapatite used as osteoconductive biomaterial in the treatment of periodontal bone defects. Clinical and radiological evaluations were conducted at 6, 12 and 18 months after the surgery. Materials and methods Forty patients with 2- and 3-wall intrabony pockets were enrolled in this study. PPD, CAL, radiographic depth (RD) and angular defects were preoperatively measured. After surgery, patients were re-evaluated every 6 months for 18 months. Statistical analyses were also performed to investigate any differences between preoperative and postoperative measurements. Results Paired t-test samples conducted on the data obtained at baseline and 18 months after, showed significant (p<0.01) differences in each measurement performed. The role of preoperative RD was demonstrated to be a significant key factor (p<0.01). A relevant correlation between preoperative PPD and CAL gain was also found. Conclusions Within the limitations of this study, the absence of anatomical variables, except the morphology of the bone defect, emphasizes the importance of the proper surgical approach and the graft material used. PMID:27486507

  10. Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response

    SciTech Connect

    Casimiro de Deus Cardoso, Cejana; Giordani, Adelmo Jose; Borri Wolosker, Angela Maria; Souhami, Luis; Gois Manso, Paulo; Souza Dias, Rodrigo; Comodo Segreto, Helena Regina; Araujo Segreto, Roberto

    2012-03-01

    Purpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation. Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. Of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptoms of the disease. Radiologic response was assessed by magnetic resonance imaging. Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical and radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy. Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy.

  11. Gallbladder and bile duct imaging: A clinical radiological approach

    SciTech Connect

    Zeman, R.K.; Burrell, M.I.

    1987-01-01

    This reference describes the clinical manifestations, imaging results, and therapeutic implications of the more common biliary disorders. The book explains the clinical significance of abnormal images. It discusses the advantages and potential pitfalls of using particular techniques in the diagnosis of specific disorders, gives recommendations for the most efficacious techniques and differentiates between physiologically-based and anatomically-oriented modalities.

  12. Cerebro-costo-mandibular syndrome: Clinical, radiological, and genetic findings.

    PubMed

    Tooley, Madeleine; Lynch, Danielle; Bernier, Francois; Parboosingh, Jillian; Bhoj, Elizabeth; Zackai, Elaine; Calder, Alistair; Itasaki, Nobue; Wakeling, Emma; Scott, Richard; Lees, Melissa; Clayton-Smith, Jill; Blyth, Moira; Morton, Jenny; Shears, Debbie; Kini, Usha; Homfray, Tessa; Clarke, Angus; Barnicoat, Angela; Wallis, Colin; Hewitson, Rebecca; Offiah, Amaka; Saunders, Michael; Langton-Hewer, Simon; Hilliard, Tom; Davis, Peter; Smithson, Sarah

    2016-05-01

    Cerebro-Costo-Mandibular syndrome (CCMS) is a rare autosomal dominant condition comprising branchial arch-derivative malformations with striking rib-gaps. Affected patients often have respiratory difficulties, associated with upper airway obstruction, reduced thoracic capacity, and scoliosis. We describe a series of 12 sporadic and 4 familial patients including 13 infants/children and 3 adults. Severe micrognathia and reduced numbers of ribs with gaps are consistent findings. Cleft palate, feeding difficulties, respiratory distress, tracheostomy requirement, and scoliosis are common. Additional malformations such as horseshoe kidney, hypospadias, and septal heart defect may occur. Microcephaly and significant developmental delay are present in a small minority of patients. Key radiological findings are of a narrow thorax, multiple posterior rib gaps and abnormal costo-transverse articulation. A novel finding in 2 patients is bilateral accessory ossicles arising from the hyoid bone. Recently, specific mutations in SNRPB, which encodes components of the major spliceosome, have been found to cause CCMS. These mutations cluster in an alternatively spliced regulatory exon and result in altered SNRPB expression. DNA was available from 14 patients and SNRPB mutations were identified in 12 (4 previously reported). Eleven had recurrent mutations previously described in patients with CCMS and one had a novel mutation in the alternative exon. These results confirm the specificity of SNRPB mutations in CCMS and provide further evidence for the role of spliceosomal proteins in craniofacial and thoracic development.

  13. Osteoarthritis in the elderly: clinical and radiological findings in 79 and 85 year olds.

    PubMed Central

    Bagge, E; Bjelle, A; Edén, S; Svanborg, A

    1991-01-01

    The prevalence of joint complaints and clinical and radiological findings of osteoarthritis in wrist, hand, and knee joints was studied in representative population subsamples of 79 and 85 year olds. Joint complaints, clinical findings of osteoarthritis, and radiographic osteoarthritis were more common in women. Age related differences in the prevalence of osteoarthritis were not found. Although there was a correlation between clinical signs of osteoarthritis and radiographic osteoarthritis, clinical signs were often present without radiographic evidence and moderate and severe radiographic osteoarthritis was often present without clinical signs. PMID:1888194

  14. Castleman Disease of the Thorax: Clinical, Radiologic, and Pathologic Correlation: From the Radiologic Pathology Archives.

    PubMed

    Kligerman, Seth J; Auerbach, Aaron; Franks, Teri J; Galvin, Jeffrey R

    2016-01-01

    Castleman disease is a complex lymphoproliferative disease pathologically divided into two subtypes, the hyaline vascular variant (HVV) and the plasma cell variant (PCV). The HVV is the most common, is thought to represent a benign neoplasm of lymph node stromal cells, and is treated with surgical resection. It is most commonly found in the mediastinum, where it classically appears as a unicentric, avidly enhancing mass at computed tomography (CT) and magnetic resonance imaging. This appearance can mimic other avidly enhancing mediastinal masses, and location, clinical history, laboratory data, and nuclear medicine single photon emission CT (SPECT) and positron emission tomography (PET) studies can help narrow the differential diagnosis. Multicentric Castleman disease (MCD), which in the majority of cases is composed of the PCV, is an aggressive lymphoproliferative disorder associated with human herpesvirus infection, interleukin 6 dysregulation, and other systemic disorders. While it can be difficult to differentiate MCD from lymphoma, the presence of avidly enhancing lymph nodes can suggest the diagnosis. The purpose of this article is to review the clinical, immunologic, and pathologic findings associated with both unicentric Castleman disease and MCD and discuss how the imaging findings correlate with the pathophysiology of the disease. PMID:27618318

  15. Hashimoto encephalopathy: A study of the clinical profile, radiological and electrophysiological correlation in a Tertiary Care Center in South India

    PubMed Central

    Sharma, Pattanagere Manjunatha Suryanarayana; Javali, Mahendra; Mahale, Rohan; Madhusudhan, Byadarahalli Kempegowda; Majeed, Anas Abdul; Srinivasa, Rangasetty

    2015-01-01

    Background: Hashimoto encephalopathy (HE) is a poorly understood and often misdiagnosed entity with variable clinical spectrum. There are many uncertainties that still remain about this condition and the pathological significance of thyroid peroxidase (TPO) antibody. Objective: To characterize the clinical, laboratory and radiologic findings in patients with HE. Design: Retrospective analysis of clinical features and diagnostic test data. Main Outcome Measures: Clinical features, laboratory, radiologic, electroencephalography (EEG) findings associated with HE and therapeutic outcome. Results: Thirteen consecutive patients were identified as having HE. The median age at onset was 48.5 years (range, 19–62 years). There was a female preponderance (76.9%). Clinical manifestations were cognitive impairment and behavioral changes in 10 (76.9%), sleep disturbance in 9 (69.2%), seizures in 6 (46.1%), headache in 4 (30.8%), psychosis or paranoia in 5 (38.5%), transient symptoms in 6 (46.1%), myoclonus in 4 (30.8%), ataxia or gait disorder in 4 (30.8%). The most frequent laboratory abnormalities were increased TPO (n = 13) in all cases, increased thyroid stimulating hormone levels (n = 6), and increased erythrocyte sedimentation rate (n = 5). The cerebrospinal fluid protein level was elevated in 8 of 9 patients (88.8%). Magnetic resonance imaging abnormalities were present in 2 patients (15.4%). EEG changes were seen in 7 patients (53.8%). All but two patients showed significant therapeutic benefit with steroids. Conclusions: HE has a wide range of clinical, laboratory, and radiologic findings. All patients with an unexplained encephalopathy should be screened for this condition as treatment response is excellent. To the best of our knowledge, this is the largest single center clinical series of HE from the Indian subcontinent. PMID:26167010

  16. Clinical-Radiological Correlation of Retained Silicone Sponge Presenting as Orbital Inflammation

    PubMed Central

    Rubinstein, Tal J.; Clemett, John; Birnbach, Charles D.; LauKaitis, Steven J.; Sires, Bryan S.

    2016-01-01

    A 32-year-old female who underwent scleral buckle removal presented 5 weeks postoperatively with a red, fluctuant subconjunctival mass. CT scan identified an irregularly bordered, hypoattenuated lesion next to the globe with the density of air. Ophthalmic plastic and reconstructive surgeons were consulted to evaluate orbital cellulitis with intraorbital gas, at which point it was deemed that the hypoattenuated mass was likely a retained sponge element based on its radiological features. Additional surgical exploration identified the retained silicone sponge. This clinical photographic-radiological correlation of retained silicone sponges presenting as orbital inflammation reminds surgeons to meticulously explant buckle material. PMID:27413562

  17. Clinical-Radiological Correlation of Retained Silicone Sponge Presenting as Orbital Inflammation.

    PubMed

    Rubinstein, Tal J; Clemett, John; Birnbach, Charles D; LauKaitis, Steven J; Sires, Bryan S

    2016-01-01

    A 32-year-old female who underwent scleral buckle removal presented 5 weeks postoperatively with a red, fluctuant subconjunctival mass. CT scan identified an irregularly bordered, hypoattenuated lesion next to the globe with the density of air. Ophthalmic plastic and reconstructive surgeons were consulted to evaluate orbital cellulitis with intraorbital gas, at which point it was deemed that the hypoattenuated mass was likely a retained sponge element based on its radiological features. Additional surgical exploration identified the retained silicone sponge. This clinical photographic-radiological correlation of retained silicone sponges presenting as orbital inflammation reminds surgeons to meticulously explant buckle material. PMID:27413562

  18. [CADASIL: a case with clinical, radiological, histological and genetic diagnoses].

    PubMed

    Posada, I J; García-Morales, I; Martínez, M A; Hoenicka, J; Bermejo, F

    2003-05-01

    Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare inherited cerebrovascular disease. The onset of clinical symptoms occurs with migraine with aura, transient ischemic attacks, recurrent subcortical ischemic infarcts, neuropsychiatric changes reaching subcortical dementia. Brain magnetic resonance images show multiple deep cerebral infarcts in white matter and basal ganglia and diffuse leukoencephalopathy. Neuropathologic hallmark consists of deposition of small electron dense granular patches related to the basement membrane of vascular smooth muscle cells with degeneration of smooth muscle cells and media and luminal obliteration. Recently, the genetic characteristics of this disorder have been reported. Missense mutations in notch3 gene localized in chromosome 19 are involved in its pathogenesis. Only three families from Spain have been reported. Here we describe a patient with typical clinical symptoms, neuroimaging and pathology of CADASIL. C406T (Arg110Cys) mutation in notch3 gene was found. We comment on the clinical symptoms of different members of the patient's family. PMID:12721871

  19. Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

    SciTech Connect

    Safari, M. J.; Wong, J. H. D.; Ng, K. H.; Jong, W. L.; Cutajar, D. L.; Rosenfeld, A. B.

    2015-05-15

    Purpose: The MOSkin is a MOSFET detector designed especially for skin dose measurements. This detector has been characterized for various factors affecting its response for megavoltage photon beams and has been used for patient dose measurements during radiotherapy procedures. However, the characteristics of this detector in kilovoltage photon beams and low dose ranges have not been studied. The purpose of this study was to characterize the MOSkin detector to determine its suitability for in vivo entrance skin dose measurements during interventional radiology procedures. Methods: The calibration and reproducibility of the MOSkin detector and its dependency on different radiation beam qualities were carried out using RQR standard radiation qualities in free-in-air geometry. Studies of the other characterization parameters, such as the dose linearity and dependency on exposure angle, field size, frame rate, depth-dose, and source-to-surface distance (SSD), were carried out using a solid water phantom under a clinical x-ray unit. Results: The MOSkin detector showed good reproducibility (94%) and dose linearity (99%) for the dose range of 2 to 213 cGy. The sensitivity did not significantly change with the variation of SSD (±1%), field size (±1%), frame rate (±3%), or beam energy (±5%). The detector angular dependence was within ±5% over 360° and the dose recorded by the MOSkin detector in different depths of a solid water phantom was in good agreement with the Markus parallel plate ionization chamber to within ±3%. Conclusions: The MOSkin detector proved to be reliable when exposed to different field sizes, SSDs, depths in solid water, dose rates, frame rates, and radiation incident angles within a clinical x-ray beam. The MOSkin detector with water equivalent depth equal to 0.07 mm is a suitable detector for in vivo skin dosimetry during interventional radiology procedures.

  20. [Clinical and radiologic manifestations of larval paragonimiasis in children].

    PubMed

    Perelśhteĭn, N N; Sipukhin, Ia M; Siuzeva, N A; Apukhtina, T P

    1991-01-01

    Investigation of 60 children with acute types and 45 children with latent types of larval paragonimiasis (LP) has revealed various clinical and x-ray manifestations of this disease, spread in the southern Primorski Territory. Three syndromes of this disease were singled out: toxico-allergic, abdominal and pulmonary. X-ray investigation showed characteristic LP symptoms: exudate in the pleural cavity, thickening of the wall, diaphragmatic and interlobular pleura, sometimes--pneumothorax. Pathology of the bronchopulmonary system manifested itself in focal and infiltrative shadows, enhanced and deformed lung markings, and bullous inflation. Diagnosis and differential diagnosis must be based on analysis of clinical and x-ray data and the results of serological reactions.

  1. Pineal cyst: a review of clinical and radiological features.

    PubMed

    Choy, Winward; Kim, Won; Spasic, Marko; Voth, Brittany; Yew, Andrew; Yang, Isaac

    2011-07-01

    Pineal cysts (PCs) are benign and often asymptomatic lesions of the pineal region that are typically small and do not change in size over time. PCs appear as small, well circumscribed, unilocular masses that either reside within or completely replace the pineal gland. This article reviews and discusses the characteristic features of PCs-clinical, histological, and identifiable by various imaging modalities-which assist clinicians in narrowing the differential diagnosis for pineal lesions. PMID:21801982

  2. Retroperitoneal bronchogenic cyst masquerading clinically and radiologically as a phaeochromocytoma.

    PubMed

    Doggett, R S; Carty, S E; Clarke, M R

    1997-07-01

    Bronchogenic cysts are relatively rare congenital anomalies that represent malformations of the embryonic foregut and are morphologically expressed as maldevelopments of the respiratory system. Anatomically, they can be positioned at any location along the central axis of the respiratory system, but are more commonly discovered in the thorax. Infradiaphragmatic bronchogenic cysts are rare and retroperitoneal ones distinctly unusual. We report a retroperitoneal bronchogenic cyst clinically masquerading as a phaeochromocytoma.

  3. Magnetoencephalography: Fundamentals and Established and Emerging Clinical Applications in Radiology

    PubMed Central

    2013-01-01

    Magnetoencephalography is a noninvasive, fast, and patient friendly technique for recording brain activity. It is increasingly available and is regarded as one of the most modern imaging tools available to radiologists. The dominant clinical use of this technology currently centers on two, partly overlapping areas, namely, localizing the regions from which epileptic seizures originate, and identifying regions of normal brain function in patients preparing to undergo brain surgery. As a consequence, many radiologists may not yet be familiar with this technique. This review provides an introduction to magnetoencephalography, discusses relevant analytical techniques, and presents recent developments in established and emerging clinical applications such as pervasive developmental disorders. Although the role of magnetoencephalography in diagnosis, prognosis, and patient treatment is still limited, it is argued that this technology is exquisitely capable of contributing indispensable information about brain dynamics not easily obtained with other modalities. This, it is believed, will make this technology an important clinical tool for a wide range of disorders in the future. PMID:24967282

  4. The cervical spine in patients with psoriatic arthritis: a clinical, radiological and immunogenetic study.

    PubMed Central

    Salvarani, C; Macchioni, P; Cremonesi, T; Mantovani, W; Battistel, B; Rossi, F; Capozzoli, N; Baricchi, R; Portioli, I

    1992-01-01

    The radiological changes of the cervical spine were evaluated in 57 patients with psoriatic arthritis and were correlated with clinical, radiological, and immunogenetic features of the disease. Forty patients (70%) showed radiological evidence of the cervical spine being affected by the disease. Two patterns of cervical spine abnormalities were noted. Fifteen patients (26%) had erosive and/or subluxing cervical rheumatoid like lesions; 25 patients (44%) had a more frequently reported pattern similar to ankylosing spondylitis. Although subaxial subluxations were the most frequently observed cervical abnormalities (53%) in the inflammatory subgroup, none of the patients studied had cord compression. Ankylosing cervical spine disease was the only form of axial involvement in nine (36%) of 25 patients with the ankylosing form of psoriatic arthritis. All of these patients had peripheral disease and were B27 negative. Predictors of cervical spine disease patterns were considered using clinical, demographic, and radiological features and HLA antigens. The results of a multivariate analysis showed that the best predictors of inflammatory cervical spine disease are the presence of HLA-B39 and HLA-DR4 antigens, radiocarpal erosions, and the absence of the HLA-DR5 antigen. PMID:1540041

  5. Ledderhose Disease: Clinical, Radiological (Ultrasound and MRI), and Anatomopathological Findings

    PubMed Central

    Omor, Y.; Dhaene, B.; Grijseels, S.; Alard, S.

    2015-01-01

    Plantar fibromatosis, or Ledderhose disease, is a rare hyperproliferative disorder of the plantar aponeurosis. It may occur at any age, with the greatest prevalence at middle age and beyond. This disorder is more common in men than woman and it is sometimes associated with other forms of fibromatosis. Diagnosis is based on clinical examination. Ultrasound (US) and magnetic resonance imaging (MRI) can be useful to confirm the diagnosis. A 44-year-old man with Ledderhose disease who underwent ultrasound and MR is described in this paper. PMID:26425380

  6. Liliequist membrane: radiological evaluation, clinical and therapeutic implications*

    PubMed Central

    Dias, Daniel Aguiar; Castro, Fábio Luiz Onuki; Yared, James Henrique; Lucas Júnior, Ademar; Ferreira Filho, Luiz Alves; Ferreira, Nelson Fortes Paes Diniz

    2014-01-01

    In a simplistic and succinct way, Liliequist membrane may be understood as a projection formed by an arachnoid membrane extending from the dorsum sellae to the mammillary bodies. In spite of being well known to neurosurgeons, many radiologists neither know this anatomical structure nor give importance to its study. The imaging evaluation of this membrane is feasible and may be interesting for a better preoperative planning; postoperative evaluation of third ventriculostomies; and understanding of suprasellar arachnoid cysts and perimesencephalic hemorrhage. The present article illustrates the anatomy of the membrane, with emphasis on imaging findings, besides describing its possible clinical and surgical implications. PMID:25741076

  7. Calibre persistent labial artery: clinical features and noninvasive radiological diagnosis.

    PubMed

    Kocyigit, P; Kocyigit, D; Akay, B N; Ustuner, E; Kisnisci, R

    2006-07-01

    Calibre persistent labial artery (CPLA) is defined as a primary arterial branch that penetrates into the submucosal tissue without division or decrease in diameter. It usually presents as an asymptomatic papule on the lower lip and can be easily misdiagnosed as a varix, haemangioma, venous lake, mucocele or fibroma. When it is ulcerated, squamous cell carcinoma is the most usual differential diagnosis. The most frequently used method to confirm the diagnosis of CPLA has been excisional biopsy, which carries the risk of profuse bleeding. Angiography, another invasive method, has also been used. Here, we report a case of a 20-year-old woman with a 5-year history of multiple CPLA lesions involving both upper and lower lips. In this case, the diagnosis was made clinically and confirmed by Doppler ultrasonography, which is a noninvasive and simple diagnostic tool. PMID:16716155

  8. Integration of basic sciences and clinical sciences in oral radiology education for dental students.

    PubMed

    Baghdady, Mariam T; Carnahan, Heather; Lam, Ernest W N; Woods, Nicole N

    2013-06-01

    Educational research suggests that cognitive processing in diagnostic radiology requires a solid foundation in the basic sciences and knowledge of the radiological changes associated with disease. Although it is generally assumed that dental students must acquire both sets of knowledge, little is known about the most effective way to teach them. Currently, the basic and clinical sciences are taught separately. This study was conducted to compare the diagnostic accuracy of students when taught basic sciences segregated or integrated with clinical features. Predoctoral dental students (n=51) were taught four confusable intrabony abnormalities using basic science descriptions integrated with the radiographic features or taught segregated from the radiographic features. The students were tested with diagnostic images, and memory tests were performed immediately after learning and one week later. On immediate and delayed testing, participants in the integrated basic science group outperformed those from the segregated group. A main effect of learning condition was found to be significant (p<0.05). The results of this study support the critical role of integrating biomedical knowledge in diagnostic radiology and shows that teaching basic sciences integrated with clinical features produces higher diagnostic accuracy in novices than teaching basic sciences segregated from clinical features.

  9. Histologic, Clinical, and Radiologic Findings of Alveolar Bone Expansion and Osteomyelitis of the Jaws in Cats.

    PubMed

    Bell, C M; Soukup, J W

    2015-09-01

    The objective of this study was to characterize clinical, radiologic, and histologic patterns of alveolar bone expansion and osteomyelitis in cats. Based on case materials submitted as surgical biopsy specimens, alveolar bone pathology was diagnosed in 28 cats. These cats had a total of 37 oral lesions with clinical and radiologic changes that involved bone and/or teeth, including periodontitis, bone expansion, tooth resorption, and/or chronic osteomyelitis; 32 lesions were evaluated by histopathology. Canine teeth were affected in 19 cats (27 affected teeth), with bilateral lesions in 5 (26.3%) cats. The caudal premolar and/or molar regions were affected in 10 cats (10 affected sites). All biopsy sites evaluated by a review of clinical images and/or radiographs had evidence of periodontitis. Clinical photographs showed expansion of alveolar bone in 13 of 16 (81%) biopsy sites evaluated. Radiologically, rarifying osseous proliferation of alveolar bone was seen at 26 of 27 (96%) biopsy sites, and tooth resorption occurred at 15 of 18 (83%) sites. Histologically, the tissue samples from canine sites had compressed trabeculae of mature remodeled bone, loose fibrous stroma with paucicellular inflammation, and mild proliferation of woven bone. Tissue samples from the premolar/molar biopsy sites were often highly cellular with mixed lymphoplasmacytic and chronic suppurative inflammation, ulceration with granulation tissue, and robust proliferation of woven bone. Alveolar bone expansion and osteomyelitis in cats occurs in conjunction with periodontal inflammation and frequently with tooth resorption.

  10. Cross infection in the high-touch areas of dental radiology clinics.

    PubMed

    Rahmatulla, M; Almas, K; al-Bagieh, N

    1996-01-01

    Disinfection and sterilization have received considerable attention due to the spread of AIDS and HIV. Several infections hazards to the patient and personnel of dental surgery have been identified from blood, saliva and water of dental unit. The high touch areas of dental x-ray equipment is a potential source of infection. The present study was undertaken to determine the extent of cross-infection present in the dental radiology clinics with and without the use of surface disinfectants. Swabs taken from high touch areas of the x-ray equipment in 15 different sessions with in one month were cultured in three different media. The study revealed, almost all high touch areas in dental radiology clinic had bacterial contamination in the absence of surface disinfection. "Webcol" and "Superficid" disinfectants showed minimum or no contamination. To remove risk of cross-infection, disinfection of high-touch areas of dental x-ray equipment is mandatory.

  11. Atypical presentation of posterior reversible encephalopathy syndrome: Clinical and radiological characteristics in eclamptic patients

    PubMed Central

    Aracki-Trenkić, Aleksandra; Stojanov, Dragan; Trenkić, Milan; Radovanović, Zoran; Ignjatović, Jelena; Ristić, Saša; Trenkić-Bozinović, Marija

    2016-01-01

    Posterior reversible encephalopathy syndrome (PRES) is an obstetric emergency frequently occurring in a pregnant or puerperal woman, manifested with an acute headache, consciousness impairment, seizures, and visual deficits and is associated with white matter changes predominantly affecting the posterior parietal and occipital lobes of the brain. Apart from the above-described typical location of the changes, the most common atypical location involves the brain stem and basal ganglia. Since magnetic resonance imaging (MRI) is more sensitive and specific imaging technique compared to computerized tomography, establishing the diagnosis and follow-up in patients with PRES is based mainly on MRI findings. It is particularly important not to exclude PRES as a possible diagnosis when we have the appropriate clinical presentation accompanied by the atypical radiological findings, since this clinical-radiological syndrome can often be manifested with an atypical MRI image.

  12. Atypical presentation of posterior reversible encephalopathy syndrome: Clinical and radiological characteristics in eclamptic patients.

    PubMed

    Aracki-Trenkić, Aleksandra; Stojanov, Dragan; Trenkić, Milan; Radovanović, Zoran; Ignjatović, Jelena; Ristić, Saša; Trenkić-Bozinović, Marija

    2016-08-01

    Posterior reversible encephalopathy syndrome (PRES) is an obstetric emergency frequently occurring in a pregnant or puerperal woman, manifested with an acute headache, consciousness impairment, seizures, and visual deficits and is associated with white matter changes predominantly affecting the posterior parietal and occipital lobes of the brain. Apart from the above-described typical location of the changes, the most common atypical location involves the brain stem and basal ganglia. Since magnetic resonance imaging (MRI) is more sensitive and specific imaging technique compared to computerized tomography, establishing the diagnosis and follow-up in patients with PRES is based mainly on MRI findings. It is particularly important not to exclude PRES as a possible diagnosis when we have the appropriate clinical presentation accompanied by the atypical radiological findings, since this clinical-radiological syndrome can often be manifested with an atypical MRI image. PMID:27483175

  13. The clinical and radiological spectrum of posterior reversible encephalopathy syndrome: the retrospective Berlin PRES study.

    PubMed

    Liman, T G; Bohner, G; Heuschmann, P U; Endres, M; Siebert, E

    2012-01-01

    The aim of the study was to characterize the clinical and radiological spectrum of posterior reversible encephalopathy syndrome (PRES) in a large cohort. The radiological report data bases of the authors' university hospitals were searched for patients with PRES. Various imaging features at onset of symptoms and on follow-up as well as clinical and paraclinical data were tabulated in those patients fulfilling the criteria for PRES. Exploratory univariate analyses were performed. A total of 96 patients with PRES were included into the study. Wide differences in lesion location, diffusivity, distribution pattern, edema severity, hemorrhage, underlying diseases, symptoms, mean arterial pressure (MAP) and coagulation status were encountered. Hemorrhage occurred significantly more frequently in patients with altered coagulation state and was significantly associated with higher edema grades and with the presence of cytotoxic edema. There was a significant difference in MAP between toxic associations with higher MAP in infection, eclampsy and autoimmune disorders, while lower MAP was found in chemotherapy and immunsupression. In 82% of patients complete or near complete resolution of edema was noted during follow-up. Higher MAP levels were associated with incomplete edema resolution. In 43% of patients residual lesions were seen with a relatively even distribution between focal gliosis, infarction, posthemorrhagic residua, atrophy and laminar necrosis. PRES in this large hospital-based retrospective study comprises a wide radiological and clinical spectrum. Residual lesions were encountered more frequently than commonly expected. Our results point towards a differential contribution of high blood pressure to the course of PRES in different underlying etiologies.

  14. Evolution of the clinical review station for enterprise-wide multimedia radiology reporting

    NASA Astrophysics Data System (ADS)

    Hanlon, William B.; Valtchinov, Vladimir I.; Davis, Scott D.; Lester, James; Khorasani, Ramin; Carrino, John A.; Benfield, Andrew

    2000-05-01

    Efforts to develop Picture Archiving and Communications Systems (PACS) for the last ten years have concentrated mainly on developing systems for primary interpretation of digital radiological images. Much less attention has been paid to the clinical aspects of the radiology process. Clinical radiology services are an important component of the overall care delivery process, providing information and consultation services to referring physicians, the customers of radiology, in a timely fashion to aid in care decisions. Information management systems (IMS) are playing an increasingly central role in the care delivery process. No suitable commercial PACS or IMS products were available that could effectively provide for the requirements of the clinicians. We endeavored to fill this void at our institution by developing a system to deliver images and text reports electronically on-demand to the referring physicians. This system has evolved substantially since initial deployment eight years ago. As new technologies become available they are evaluated and integrated as appropriate to improve system performance and manageability. Not surprisingly, the internet and World Wide Web (WWW) technology has had the greatest impact on system design in recent years. Additional features have been added over time to provide services for teleradiology, teaching, and research needs. We also discovered that these value-added services give us a competitive edge in attracting new business to our department. Commercial web-based products are now becoming available which do a satisfactory job of providing many of these clinical services. These products are evaluated for integration into our system as they mature. The result is a system that impacts positively on patient care.

  15. Bridging the gap between basic and clinical sciences: A description of a radiological anatomy course.

    PubMed

    Torres, Anna; Staśkiewicz, Grzegorz J; Lisiecka, Justyna; Pietrzyk, Łukasz; Czekajlo, Michael; Arancibia, Carlos U; Maciejewski, Ryszard; Torres, Kamil

    2016-05-01

    A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images requires the practitioner to not only hone certain technical skills, but to command an excellent knowledge of sectional anatomy and an understanding of the pathophysiology of the examined areas as well. Yet throughout many medical curricula there is often a large gap between traditional anatomy coursework and clinical training in imaging techniques. The authors present a radiological anatomy course developed to teach sectional anatomy with particular emphasis on ultrasonography and computed tomography, while incorporating elements of medical simulation. To assess students' overall opinions about the course and to examine its impact on their self-perceived improvement in their knowledge of radiological anatomy, anonymous evaluation questionnaires were provided to the students. The questionnaires were prepared using standard survey methods. A five-point Likert scale was applied to evaluate agreement with statements regarding the learning experience. The majority of students considered the course very useful and beneficial in terms of improving three-dimensional and cross-sectional knowledge of anatomy, as well as for developing practical skills in ultrasonography and computed tomography. The authors found that a small-group, hands-on teaching model in radiological anatomy was perceived as useful both by the students and the clinical teachers involved in their clinical education. In addition, the model was introduced using relatively few resources and only two faculty members. Anat Sci Educ 9: 295-303. © 2015 American Association of Anatomists.

  16. Bridging the gap between basic and clinical sciences: A description of a radiological anatomy course.

    PubMed

    Torres, Anna; Staśkiewicz, Grzegorz J; Lisiecka, Justyna; Pietrzyk, Łukasz; Czekajlo, Michael; Arancibia, Carlos U; Maciejewski, Ryszard; Torres, Kamil

    2016-05-01

    A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images requires the practitioner to not only hone certain technical skills, but to command an excellent knowledge of sectional anatomy and an understanding of the pathophysiology of the examined areas as well. Yet throughout many medical curricula there is often a large gap between traditional anatomy coursework and clinical training in imaging techniques. The authors present a radiological anatomy course developed to teach sectional anatomy with particular emphasis on ultrasonography and computed tomography, while incorporating elements of medical simulation. To assess students' overall opinions about the course and to examine its impact on their self-perceived improvement in their knowledge of radiological anatomy, anonymous evaluation questionnaires were provided to the students. The questionnaires were prepared using standard survey methods. A five-point Likert scale was applied to evaluate agreement with statements regarding the learning experience. The majority of students considered the course very useful and beneficial in terms of improving three-dimensional and cross-sectional knowledge of anatomy, as well as for developing practical skills in ultrasonography and computed tomography. The authors found that a small-group, hands-on teaching model in radiological anatomy was perceived as useful both by the students and the clinical teachers involved in their clinical education. In addition, the model was introduced using relatively few resources and only two faculty members. Anat Sci Educ 9: 295-303. © 2015 American Association of Anatomists. PMID:26599321

  17. Clinical, physiological, and radiological features of asthma–chronic obstructive pulmonary disease overlap syndrome

    PubMed Central

    Suzuki, Toshio; Tada, Yuji; Kawata, Naoko; Matsuura, Yukiko; Ikari, Jun; Kasahara, Yasunori; Tatsumi, Koichiro

    2015-01-01

    Background Asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is associated with rapid decline in lung function, poorer health-related quality-of-life outcomes, and frequent exacerbations, compared to COPD alone. Although the numbers of patients with ACOS have increased, there is little established evidence regarding diagnostic criteria and treatment options. Thus, the aim of our study was to clarify the clinical, physiological, and radiological features of patients with ACOS. Methods We examined a total of 100 patients with COPD and 40 patients with ACOS, who were selected based on clinical criteria. All patients underwent baseline testing, including a COPD assessment test, pulmonary function tests, and multidetector row computed tomography imaging. Percentage of low attenuation volume, percentage of wall area, and percentage of total cross-sectional area of pulmonary vessels less than 5 mm2 (%CSA <5) were determined using multidetector row computed tomography. ACOS patients were administered a fixed dose of budesonide/formoterol (160/4.5 μg, two inhalations; twice daily) for 12 weeks, after which the ACOS patients underwent multidetector row computed tomography to measure the same parameters. Results At baseline, the ACOS patients and COPD patients had a similar degree of airflow limitation, vital capacity, and residual volume. ACOS patients had higher COPD assessment test scores, percentage of wall area, and %CSA <5 than COPD patients. Compared to baseline, budesonide/formoterol treatment significantly increased the forced expiratory volume in 1 second and decreased the degree of airway wall thickness (percentage of wall area) as well as pulmonary microvascular density (%CSA <5) in ACOS patients. Conclusion Our results suggest that ACOS is characterized by an airway lesion–dominant phenotype, in contrast to COPD. Higher %CSA <5 might be a characteristic feature of ACOS. PMID:26028967

  18. Clinical and radiological repercussions of plexiform neurofibroma in the pelvic region.

    PubMed

    Slaibi, Érica Bertolace; Daher, João Gabriel Lima; da Fonseca, Gustavo Guida Godinho; Daher, Carlos Magno; Geller, Mauro; Ribeiro, Márcia Gonçalves

    2014-01-01

    The authors report the case of a plexiform neurofibroma located in the pelvis, affecting the bladder, prostate and spine (lumbar/sacral), followed-up for three years and six months. Surgical removal was contraindicated and the patient underwent biannual clinical and radiological follow-up that did not demonstrate any tumor increase. The clinical manifestations of neurofibromatosis type 1 are variable, and the medical team should be attentive to further investigations, considering possible unexpected rare findings. Large pelvic masses may correspond to plexiform neurofibromas, so the diagnostic hypothesis of neurofibromatosis should be taken into consideration.

  19. Clinical and radiological repercussions of plexiform neurofibroma in the pelvic region*

    PubMed Central

    Slaibi, Érica Bertolace; Daher, João Gabriel Lima; da Fonseca, Gustavo Guida Godinho; Daher, Carlos Magno; Geller, Mauro; Ribeiro, Márcia Gonçalves

    2014-01-01

    The authors report the case of a plexiform neurofibroma located in the pelvis, affecting the bladder, prostate and spine (lumbar/sacral), followed-up for three years and six months. Surgical removal was contraindicated and the patient underwent biannual clinical and radiological follow-up that did not demonstrate any tumor increase. The clinical manifestations of neurofibromatosis type 1 are variable, and the medical team should be attentive to further investigations, considering possible unexpected rare findings. Large pelvic masses may correspond to plexiform neurofibromas, so the diagnostic hypothesis of neurofibromatosis should be taken into consideration. PMID:25741110

  20. Decision support systems for clinical radiological practice — towards the next generation

    PubMed Central

    Stivaros, S M; Gledson, A; Nenadic, G; Zeng, X-J; Keane, J; Jackson, A

    2010-01-01

    The huge amount of information that needs to be assimilated in order to keep pace with the continued advances in modern medical practice can form an insurmountable obstacle to the individual clinician. Within radiology, the recent development of quantitative imaging techniques, such as perfusion imaging, and the development of imaging-based biomarkers in modern therapeutic assessment has highlighted the need for computer systems to provide the radiological community with support for academic as well as clinical/translational applications. This article provides an overview of the underlying design and functionality of radiological decision support systems with examples tracing the development and evolution of such systems over the past 40 years. More importantly, we discuss the specific design, performance and usage characteristics that previous systems have highlighted as being necessary for clinical uptake and routine use. Additionally, we have identified particular failings in our current methodologies for data dissemination within the medical domain that must be overcome if the next generation of decision support systems is to be implemented successfully. PMID:20965900

  1. Radiological protection in ion beam radiotherapy: practical guidance for clinical use of new technology.

    PubMed

    Yonekura, Y; Tsujii, H; Hopewell, J W; Ortiz López, P; Cosset, J-M; Paganetti, H; Montelius, A; Schardt, D; Jones, B; Nakamura, T

    2016-06-01

    Recently introduced technologies in radiotherapy have significantly improved the clinical outcome for patients. Ion beam radiotherapy, involving proton and carbon ion beams, provides excellent dose distributions in targeted tumours, with reduced doses to the surrounding normal tissues. However, careful treatment planning is required in order to maximise the treatment efficiency and minimise the dose to normal tissues. Radiation exposure from secondary neutrons and photons, particle fragments, and photons from activated materials should also be considered for radiological protection of the patient and medical staff. Appropriate maintenance is needed for the equipment and air in the treatment room, which may be activated by the particle beam and its secondary radiation. This new treatment requires complex procedures and careful adjustment of parameters for each patient. Therefore, education and training for the personnel involved in the procedure are essential for both effective treatment and patient protection. The International Commission on Radiological Protection (ICRP) has provided recommendations for radiological protection in ion beam radiotherapy in Publication 127 Medical staff should be aware of the possible risks resulting from inappropriate use and control of the equipment. They should also consider the necessary procedures for patient protection when new technologies are introduced into clinical practice.

  2. Radiological protection in ion beam radiotherapy: practical guidance for clinical use of new technology.

    PubMed

    Yonekura, Y; Tsujii, H; Hopewell, J W; Ortiz López, P; Cosset, J-M; Paganetti, H; Montelius, A; Schardt, D; Jones, B; Nakamura, T

    2016-06-01

    Recently introduced technologies in radiotherapy have significantly improved the clinical outcome for patients. Ion beam radiotherapy, involving proton and carbon ion beams, provides excellent dose distributions in targeted tumours, with reduced doses to the surrounding normal tissues. However, careful treatment planning is required in order to maximise the treatment efficiency and minimise the dose to normal tissues. Radiation exposure from secondary neutrons and photons, particle fragments, and photons from activated materials should also be considered for radiological protection of the patient and medical staff. Appropriate maintenance is needed for the equipment and air in the treatment room, which may be activated by the particle beam and its secondary radiation. This new treatment requires complex procedures and careful adjustment of parameters for each patient. Therefore, education and training for the personnel involved in the procedure are essential for both effective treatment and patient protection. The International Commission on Radiological Protection (ICRP) has provided recommendations for radiological protection in ion beam radiotherapy in Publication 127 Medical staff should be aware of the possible risks resulting from inappropriate use and control of the equipment. They should also consider the necessary procedures for patient protection when new technologies are introduced into clinical practice. PMID:26980799

  3. Decision support systems for clinical radiological practice -- towards the next generation.

    PubMed

    Stivaros, S M; Gledson, A; Nenadic, G; Zeng, X-J; Keane, J; Jackson, A

    2010-11-01

    The huge amount of information that needs to be assimilated in order to keep pace with the continued advances in modern medical practice can form an insurmountable obstacle to the individual clinician. Within radiology, the recent development of quantitative imaging techniques, such as perfusion imaging, and the development of imaging-based biomarkers in modern therapeutic assessment has highlighted the need for computer systems to provide the radiological community with support for academic as well as clinical/translational applications. This article provides an overview of the underlying design and functionality of radiological decision support systems with examples tracing the development and evolution of such systems over the past 40 years. More importantly, we discuss the specific design, performance and usage characteristics that previous systems have highlighted as being necessary for clinical uptake and routine use. Additionally, we have identified particular failings in our current methodologies for data dissemination within the medical domain that must be overcome if the next generation of decision support systems is to be implemented successfully.

  4. Measurements of entrance surface dose using a fiber-optic dosimeter in diagnostic radiology

    NASA Astrophysics Data System (ADS)

    Yoo, Wook Jae; Seo, Jeong Ki; Shin, Sang Hun; Han, Ki-Tek; Jeon, Dayeong; Jang, Kyoung Won; Sim, Hyeok In; Lee, Bongsoo; Park, Jang-Yeon

    2013-03-01

    In this study, a fiber-optic dosimeter (FOD) was developed to measure entrance surface dose (ESD) in diagnostic radiology. We measured the scintillating lights in order to obtain ESDs, which changed with the various exposure parameters of a digital radiography (DR) system, such as tube potential, current-time product, focus-surface distance (FSD), and field size, using the fabricated FOD system. From the experimental results, the output light signals of the FOD were similar to the ESDs of the conventional semiconductor dosimeter. In conclusion, we characterized the measured ESDs as functions of exposure parameters by using two different types of dosimeters and demonstrated that the proposed FOD using a plastic scintillating fiber and a plastic optical fiber (POF) makes it possible to measure ESDs in the energy range of diagnostic radiology. From the results of this study, it is anticipated that the FOD will be a useful dosimeter in low-energy photon applications including diagnostic radiology.

  5. Virtual anthropology: useful radiological tools for age assessment in clinical forensic medicine and thanatology.

    PubMed

    Dedouit, Fabrice; Saint-Martin, Pauline; Mokrane, Fatima-Zohra; Savall, Frédéric; Rousseau, Hervé; Crubézy, Eric; Rougé, Daniel; Telmon, Norbert

    2015-09-01

    Virtual anthropology consists of the introduction of modern slice imaging to biological and forensic anthropology. Thanks to this non-invasive scientific revolution, some classifications and staging systems, first based on dry bone analysis, can be applied to cadavers with no need for specific preparation, as well as to living persons. Estimation of bone and dental age is one of the possibilities offered by radiology. Biological age can be estimated in clinical forensic medicine as well as in living persons. Virtual anthropology may also help the forensic pathologist to estimate a deceased person's age at death, which together with sex, geographical origin and stature, is one of the important features determining a biological profile used in reconstructive identification. For this forensic purpose, the radiological tools used are multislice computed tomography and, more recently, X-ray free imaging techniques such as magnetic resonance imaging and ultrasound investigations. We present and discuss the value of these investigations for age estimation in anthropology.

  6. [Osteo-articular amyloidosis caused by dialysis. Clinical and radiologic aspects].

    PubMed

    Baldrati, L; Brunetti, L; Rocchi, A; Bonsanto, R; Docci, D; Turci, F

    1990-10-01

    Twenty-nine patients who had received chronic hemodialysis for more than 5 years provided the material for the present study. In 12 of them (41%) there were radiological findings of dialysis related amyloidosis, mainly destructive spondyloarthropathy of the cervical spine (n = 11) and geodes of the shoulder (n = 5). When compared with negative patients, these patients were significantly older (p less than 0.001 and had been dialyzed for longer periods of time (p less than 0.01). Moreover, in such patients there was an higher incidence of carpal tunnel syndrome (p less than 0.025) and shoulder pain (p less than 0.001). Our results confirm that osteoarticular amyloidosis is a frequent long-term complication of chronic hemodialysis and underline the correlation between clinical and radiological findings.

  7. Virtual anthropology: useful radiological tools for age assessment in clinical forensic medicine and thanatology.

    PubMed

    Dedouit, Fabrice; Saint-Martin, Pauline; Mokrane, Fatima-Zohra; Savall, Frédéric; Rousseau, Hervé; Crubézy, Eric; Rougé, Daniel; Telmon, Norbert

    2015-09-01

    Virtual anthropology consists of the introduction of modern slice imaging to biological and forensic anthropology. Thanks to this non-invasive scientific revolution, some classifications and staging systems, first based on dry bone analysis, can be applied to cadavers with no need for specific preparation, as well as to living persons. Estimation of bone and dental age is one of the possibilities offered by radiology. Biological age can be estimated in clinical forensic medicine as well as in living persons. Virtual anthropology may also help the forensic pathologist to estimate a deceased person's age at death, which together with sex, geographical origin and stature, is one of the important features determining a biological profile used in reconstructive identification. For this forensic purpose, the radiological tools used are multislice computed tomography and, more recently, X-ray free imaging techniques such as magnetic resonance imaging and ultrasound investigations. We present and discuss the value of these investigations for age estimation in anthropology. PMID:25735613

  8. A Clinical Update and Radiologic Review of Pediatric Orbital and Ocular Tumors

    PubMed Central

    Rao, Ajay A.; Naheedy, John H.; Chen, James Y.-Y.; Robbins, Shira L.; Ramkumar, Hema L.

    2013-01-01

    While pediatric orbital tumors are most often managed in tertiary care centers, clinicians should be aware of the signs of intraocular and orbital neoplasms. In the pediatric population, a delay in diagnosis of orbital and intraocular lesions, even if benign, can lead to vision loss and deformity. Intraocular lesions reviewed are retinoblastoma, medulloepithelioma, and retinal astrocytic hamartoma. Orbital neoplasms reviewed are rhabdomyosarcoma, neuroblastoma metastases, optic pathway glioma, plexiform neurofibroma, leukemia, lymphoprolipherative disease, orbital inflammatory syndrome, dermoid and epidermoid inclusion cysts, and Langerhans' cell histiocytosis. Vascular lesions reviewed are infantile hemangioma and venous lymphatic malformation. In conjunction with clinical examination, high-resolution ophthalmic imaging and radiologic imaging play an important role in making a diagnosis and differentiating between benign and likely malignant processes. The radiologic imaging characteristics of these lesions will be discussed to facilitate prompt diagnosis and treatment. The current treatment modalities and management of tumors will also be reviewed. PMID:23577029

  9. Clinical Effects and Radiological Results of Vertebroplasty: Over a 2-year Follow-Up Period

    PubMed Central

    Nam, Han Ga Wi; Shin, Il Young; Moon, Seung-Myung; Hwang, Hyung Sik

    2012-01-01

    Objective We investigated the association between clinical and radiological results and assessed the radiological changes according to the distribution pattern and amount of injected cement after vertebroplasty. Methods Two hundred and one patients underwent vertebroplasty; of these, 15 were follow up for more than 2 years. For radiological analysis, we grouped the patients according to cement distribution as follows: group 1, unilateral, unilateral distribution of cement; group 2, bilateral-uneven, bilateral distribution of cement but separated mass; and group 3, bilateral-even, bilateral single mass of cement. To compare radiologic with clinical results, we assessed the visual analogue scale (VAS) score, amount of injected cement, bone mineral density (BMD), postoperative and follow-up vertebral body compression ratios, and postoperative and follow-up kyphotic angles. Results There were 4 (26.7%) patients in group 1, 6 (40.0%) in group 2, and 5 (33.3%) in group 3. The mean VAS score was 5.2 preoperatively, 1.8 postoperatively, and 3.2 at 2-year follow-up. The 2-year follow-up compression ratio was better in patients with even distribution of injected cement (group 2 and 3) than group 1. However, it was not statistically insignificant (p>0.05). The follow-up kyphotic angle was more aggravated in the group 1 than in the other groups (p<0.05). Conclusion Our study showed that vertebroplasty had a beneficial effect on pain relief, particularly in the immediate postoperative stage. The augmented spine tended to be more stable in the cases with increased amount and more even distribution of injected cement. PMID:25983842

  10. Shoulder Structure and Function Following the Modified Latarjet Procedure: A Clinical and Radiological Review

    PubMed Central

    Garewal, Devinder; Evans, Mathew; Taylor, David; Hoy, Gregory A.; Barwood, Shane; Connell, David

    2013-01-01

    Background To evaluate the clinical and radiological outcomes of the modified Latarjet procedure for traumatic, antero-inferior glenohumeral joint instability. Methods Case series were used with a mean follow-up of 21.3 months for clinical and radiological review and 47.2 months for recurrent instability. Shoulder function was evaluated by clinical examination and validated shoulder scales: Western Ontario Shoulder Stability Index (WOSI), Melbourne Instability Shoulder Score (MISS) and l'Insalata Shoulder Questionnaire. Shoulder structure was evaluated by computed tomography. Results Thirty-two cases were enrolled (mean age 27.0 years). One patient reported a redislocation during the follow-up period. Clinical examination revealed that the median external rotation (at 0° and 90° abduction) was reduced on the operative side by 7.5° (p < 0.01) and 10° (p < 0.001), respectively. Subjective shoulder function was good. Mean (SD) scores on the WOSI, MISS and l'Insalata scales were 78.0 (19.7), 75.8 (11.5) and 89.3 (9.9), respectively. No loss of subscapularis strength was identified (p > 0.05). Radiological evaluation revealed a mean (SD) pre-operative glenoid surface area loss of 169.5 (48.5) mm2 reconstituted surgically by a bone block of 225.4 (73.8) mm2. Subscapularis muscle bulk was reduced on the operative side, above the level of the muscle split (p < 0.05). Conclusions The Latarjet procedure reliably restores lost glenoid surface area, shoulder stability, strength and function. A small loss of external rotation is expected and related to altered subscapularis anatomy. PMID:27582905

  11. Clinical and Radiological Comparison of Semirigid (WavefleX) and Rigid System for the Lumbar Spine

    PubMed Central

    Kim, Do-Keun; Lim, Hyunkeun; Oh, Chang Hyun

    2016-01-01

    Objective Spinal fusion operation is an effective treatment in the spinal pathology, but it could change the physiological distribution of load at the instrumented and adjacent segments. This retrospective study compared the radiological and clinical outcomes of patients undergoing lumbar fusion with semirigid rods versus rigid rods system. Methods Using transpedicular fixation and posterior lumbar interbody fusion at the level of L4/L5, 20 patients were treated with semirigid rods (WavefleX, SR group), and 20 patients with rigid rods (titanium, RR group). Clinical and radiological outcomes were evaluated, including visual analog score for lower back pain and leg pain, Prolo functional and economic scores, statues of implanted instruments, fusion rate, and complications during 24-month follow-up. Results Clinical scores were significantly improved until postoperative 24-month follow-up as compared with preoperative scores in both groups (p<0.05), with similar levels of improvement observed at the same time points postoperatively between the 2 groups. Prolo economic scores were significantly improved in SR group compared to RR until 12 months, but this improvement became similar after 18 months. The overall fusion rate was 94.1% until the 24-month follow-up for both groups. No significant complication was observed in both groups. Conclusion The results of the present study indicate that semirigid rods system with posterior lumbar interbody fusion showed similar clinical and radiological result with rigid rods system until 2 years after instrumentation. The WavefleX rods system, as a semirigid rods with unique characteristics, may be an effective alternative treatment for patients in lumbar fusion. PMID:27437014

  12. [Clinical and radiologic study of hereditary diseases of the femoral epiphysis].

    PubMed

    Mayén, D G; Carnevale, A; Takenaga, R; Lizalde, A; del Castillo, V

    1991-01-01

    The diseases that involve the proximal femoral epiphysis are an heterogeneous group with similar clinical characteristics, so it is important to establish a differential diagnosis to bring suitable management and genetic counseling. The present study includes 33 patients: eleven with multiple epiphyseal dysplasia (MED), five with spondylo-epiphyseal dysplasia (SED), twelve with unilateral Perthes disease (PD uni) and five with bilateral Perthes disease (PD bi). The clinical study showed that affected relatives and associated clinical manifestations were more frequent in the dysplastic patients. The somatometric profile of the 17 PD patients was within two standard deviations of the average, whereas the dysplastic patients showed short stature. In the radiological study all patients had one or both proximal femoral epiphysis affected. All the dysplastic patients had other irregular or flattened epiphysis, but only half of those with PD showed mild flattening or distal femoral epiphysis. Eight of 29 patients had a delay in bone maturity, and all patients had mild flattened vertebras. We think this study shows the importance of having sufficient clinic and radiologic criteria to establish the differential diagnosis in view of the heterogeneity of these entities. PMID:1798872

  13. LMNB1‐related autosomal‐dominant leukodystrophy: Clinical and radiological course

    PubMed Central

    Sundblom, Jimmy; Dahl, Niklas; Melberg, Atle; Raininko, Raili

    2015-01-01

    Objective Duplication of the LMNB1 gene encoding lamin B1 causes adult‐onset autosomal‐dominant leukodystrophy (ADLD) starting with autonomic symptoms, which are followed by pyramidal signs and ataxia. Magnetic resonance imaging (MRI) of the brain reveals characteristic findings. This is the first longitudinal study on this disease. Our objective is to describe the natural clinical and radiological course of LMNB1‐related ADLD. Methods Twenty‐three subjects in two families with LMNB1 duplications were studied over two decades with clinical assessment and MRI of the brain and spinal cord. They were 29 to 70 years old at their first MRI. Repeated MRIs were performed in 14 subjects over a time period of up to 17 years. Results Pathological MRI findings were found in the brain and spinal cord in all examinations (i.e., even preceding clinical symptoms). MRI changes and clinical symptoms progressed in a definite order. Autonomic dysfunction appeared in the fifth to sixth decade, preceding or together with gait and coordination difficulties. Motor signs developed ascending from spastic paraplegia to tetraplegia and pseudobulbar palsy in the seventh decade. There were clinical, radiological, and neurophysiological signs of myelopathy. Survival lasted more than two decades after clinical onset. Interpretation LMNB1‐related ADLD is a slowly progressive neurological disease. MRI abnormalities of the brain and spinal cord can precede clinical symptoms by more than a decade and are extensive in all symptomatic patients. Spinal cord involvement is a likely contributing factor to early autonomic symptoms and spastic paraplegia. Ann Neurol 2015;78:412–425 PMID:26053668

  14. Infection with Ureaplasma urealyticum: is there a specific clinical and radiological course in the preterm infant?

    PubMed Central

    Theilen, U; Lyon, A; Fitzgerald, T; Hendry, G; Keeling, J

    2004-01-01

    Background: Despite having mild early respiratory disease, many preterm babies develop chronic lung disease (CLD). Intrauterine infection with Ureaplasma urealyticum has been associated with preterm labour and CLD. Objective: To test the hypothesis that infection with U urealyticum results in a specific clinical and radiological picture in the first 10 days of life. Methods: Retrospective study of 60 ventilated babies < 30 weeks gestation, who had tracheal secretions tested for U urealyticum. Placental histology was reviewed by a paediatric pathologist for signs of chorioamnionitis. Chest radiographs were independently reviewed by two paediatric radiologists according to previously agreed criteria. All reviewers were blinded to the infection status of the babies. Results: Twenty five babies were U urealyticum positive. These were more likely to experience chorioamnionitis (p = 0.004), premature rupture of membranes (p = 0.01), and spontaneous vaginal delivery (p = 0.09). U urealyticum positive babies had fewer signs of respiratory distress syndrome on early chest radiographs (p = 0.038), and they could be weaned from their ventilation settings (fraction of inspired oxygen (FIO2) and mean airway pressure) more quickly in the first few days. Subsequently U urealyticum positive babies deteriorated clinically and radiologically. More often they required ventilation to be restarted (p = 0.051), a higher proportion being ventilated on day 10 (p = 0.027) with higher FIO2 (p = 0.001) and mean airway pressure (p = 0.002). Their chest radiographs showed more emphysematous changes as early as day 5 (p = 0.045), with a pronounced difference by day 10 (p = 0.009). Conclusions: Preterm ventilated babies with U urealyticum in their tracheal secretions have a different clinical and radiological course, with less acute lung disease but early onset of CLD, compared with those with negative cultures. PMID:14977904

  15. Clinical predictors of acute radiological pneumonia and hypoxaemia at high altitude.

    PubMed Central

    Lozano, J M; Steinhoff, M; Ruiz, J G; Mesa, M L; Martinez, N; Dussan, B

    1994-01-01

    Fast breathing has been recommended as a predictor of childhood pneumonia. Children living at high altitude, however, may breathe faster in response to the lower oxygen partial pressure, which may change the accuracy of prediction of a high respiratory rate. To assess the usefulness of clinical manifestations in the diagnosis of radiological pneumonia or hypoxaemia, or both, at high altitude (2640 m above sea level), 200 children aged 7 days to 36 months presenting to an urban emergency room with cough lasting less than seven days were studied. Parents were interviewed and the children evaluated using standard forms. The results of chest radiographs and pulse oximetry obtained after clinical examination were interpreted blind. Radiological pneumonia and haemoglobin oxygen saturation < 88% were used as 'gold standards'. One hundred and thirty (65%) and 125 (63%) children had radiological pneumonia and hypoxaemia respectively. Crepitations and decreased breath sounds were statistically associated with pneumonia, and rapid breathing as perceived by the child's mother, chest retractions, nasal flaring, and crepitations with hypoxaemia. The best single predictor of the presence of pneumonia is a high respiratory rate, although the results are not as good as those reported by other studies. A respiratory rate > or = 50/minute had good sensitivity (76%) and specificity (71%) for hypoxaemia in infants. Hypoxaemia had a good sensitivity and specificity for pneumonia mainly in infants (83% and 73%, respectively). Logistic regression analysis showed that decreased or increased respiratory sounds and crepitations were associated with pneumonia, and that hypoxaemia is the best predictor when auscultatory findings are excluded. These results suggest that some clinical predictors appear to be less accurate in Bogota than in places at lower altitude, and that pulse oximetry can be used for predicting pneumonia. PMID:7979525

  16. Orthopaedic radiology

    SciTech Connect

    Park, W.M.; Hughes, S.P.F.

    1987-01-01

    This book is an account of the principles of modern diagnostic imaging techniques and their applications in orthopedics. The aim is to show radiology as a dynamic subject. Orthopaedic Radiology is divided into two sections with the first part focusing on the principles of diagnostic imaging and interpretation and the second applying this information to practical clinical problems.

  17. Radiological and clinical characterization of the lysosomal storage disorders: non-lipid disorders

    PubMed Central

    Parker, E I; Moreno-De-Luca, A; Harmouche, E; Terk, M R

    2014-01-01

    Lysosomal storage diseases (LSDs) are a large group of genetic metabolic disorders that result in the accumulation of abnormal material, such as mucopolysaccharides, glycoproteins, amino acids and lipids, within cells. Since many LSDs manifest during infancy or early childhood, with potentially devastating consequences if left untreated, timely identification is imperative to prevent irreversible damage and early death. In this review, the key imaging features of the non-lipid or extralipid LSDs are examined and correlated with salient clinical manifestations and genetic information. Disorders are stratified based on the type of excess material causing tissue or organ dysfunction, with descriptions of the mucopolysaccharidoses, mucolipidoses, alpha-mannosidosis, glycogen storage disorder II and cystinosis. In addition, similarities and differences in radiological findings between each of these LSDs are highlighted to facilitate further recognition. Given the rare and extensive nature of the LSDs, mastery of their multiple clinical and radiological traits may seem challenging. However, an understanding of the distinguishing imaging characteristics of LSDs and their clinical correlates may allow radiologists to play a key role in the early diagnosis of these progressive and potentially fatal disorders. PMID:24234586

  18. Pleomorphic adenoma (benign mixed tumour) of the salivary glands: its diverse clinical, radiological, and histopathological presentation.

    PubMed

    Lingam, Ravi K; Daghir, Ahmed A; Nigar, Ezra; Abbas, Syeda A B; Kumar, Mahesh

    2011-01-01

    Pleomorphic adenoma is the single most common salivary gland tumour. It has a diverse histological presentation because of varying proportions of different epithelial and mesenchymal elements, and presents clinically and radiologically in various ways as it occurs at many different sites in the head and neck region. The choice of imaging is influenced by its site and size, and a range of options for treatment includes both operation and radiotherapy. The tumour can also present in various ways if it is not removed or treated successfully.

  19. Radiologist-initiated double reading of abdominal CT: retrospective analysis of the clinical importance of changes to radiology reports

    PubMed Central

    Andersen, Jack Gunnar; Stokke, Mali Victoria; Tennstrand, Anne Lise; Aamodt, Rolf; Heggelund, Thomas; Dahl, Fredrik A; Sandbæk, Gunnar; Hurlen, Petter

    2016-01-01

    Background Misinterpretation of radiological examinations is an important contributing factor to diagnostic errors. Consultant radiologists in Norwegian hospitals frequently request second reads by colleagues in real time. Our objective was to estimate the frequency of clinically important changes to radiology reports produced by these prospectively obtained double readings. Methods We retrospectively compared the preliminary and final reports from 1071 consecutive double-read abdominal CT examinations of surgical patients at five public hospitals in Norway. Experienced gastrointestinal surgeons rated the clinical importance of changes from the preliminary to final report. The severity of the radiological findings in clinically important changes was classified as increased, unchanged or decreased. Results Changes were classified as clinically important in 146 of 1071 reports (14%). Changes to 3 reports (0.3%) were critical (demanding immediate action), 35 (3%) were major (implying a change in treatment) and 108 (10%) were intermediate (requiring further investigations). The severity of the radiological findings was increased in 118 (81%) of the clinically important changes. Important changes were made less frequently when abdominal radiologists were first readers, more frequently when they were second readers, and more frequently to urgent examinations. Conclusion A 14% rate of clinically important changes made during double reading may justify quality assurance of radiological interpretation. Using expert second readers and a targeted selection of urgent cases and radiologists reading outside their specialty may increase the yield of discrepant cases. PMID:27013638

  20. Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey

    SciTech Connect

    Haslam, Philip J.; Yap, Bernard; Mueller, Peter R.; Lee, Michael J.

    2000-07-15

    Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends.Methods: A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived from a similar survey of interventional practice in the United States.Results: Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds.Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are

  1. Clinical research and diagnostic efficacy studies in the oral and maxillofacial radiology literature: 1996–2005

    PubMed Central

    Kim, IH; Patel, MJ; Hirt, SL; Kantor, ML

    2011-01-01

    Objectives The aim of this study was to determine the level of evidence that is published in the oral and maxillofacial radiology (OMR) literature. Methods OMR papers published in Dentomaxillofacial Radiology and Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology between 1996 and 2005 were classified using epidemiological study design and diagnostic efficacy hierarchies. The country of origin and number of authors were noted. Results Of the 725 articles, 384 could be classified with the epidemiological study design hierarchy: 155 (40%) case reports/series and 207 (54%) cross-sectional studies. The distribution of study designs was not statistically significant across time (Fisher's exact test, P = 0.06) or regions (P = 0.89). The diagnostic efficacy hierarchy was applicable to 246 articles: 71 (29%) technical efficacy and 166 (67%) diagnostic accuracy studies. The distribution of efficacy levels was not statistically significant across time (P = 0.22) but was significant across regions (P < 0.01). Authors from Japan produced 26% of the papers with a mean ± standard deviation of 5.78 ± 1.98 authors per paper (APP); American authors, 23% (3.78 ± 1.72 APP); and all others, 51% (3.76 ± 1.51 APP). Conclusion The OMR literature consisted mostly of case reports/series, cross-sectional, technical efficacy and diagnostic accuracy studies. Such studies do not provide strong evidence for clinical decision making nor do they address the impact of diagnostic imaging on patient care. More studies at the higher end of the study design and efficacy hierarchies are needed in order to make wise choices regarding clinical decisions and resource allocations. PMID:21697152

  2. Radioactivity: Recommendations of the International Commission on Radiological Units and Measurements (1962), (ICRU) Report 10 c.

    ERIC Educational Resources Information Center

    National Bureau of Standards (DOC), Washington, DC.

    This handbook presents recommendations agreed upon at the meeting of the International Commission on Radiological Units and Measurements (ICRU) held in Montreux, Switzerland, in April 1962. It is written in a report form with a preface including symbols, abbreviations and definitions of terms used in the report. The report consists of four…

  3. Metabolic disorders with clinical and radiologic features of sporadic Creutzfeldt-Jakob disease

    PubMed Central

    Rosenbloom, Michael H.; Tartaglia, M. Carmela; Forner, Sven A.; Wong, Katherine K.; Kuo, Amy; Johnson, David Y.; Colacurcio, Valerie; Andrews, Bret D.; Miller, Bruce L.; DeArmond, Stephen J.

    2015-01-01

    Summary Two patients with metabolic disorders presented with clinical and radiologic features suggestive of sporadic Creutzfeldt-Jakob disease (sCJD). Case 1 was a 50-year-old man with rapid decline in cognitive, behavioral, and motor function following new-onset seizures. MRI was read as consistent with CJD, and he was referred for a treatment trial, but it was determined that he recently experienced rapid correction of hyponatremia resulting in extrapontine myelinolysis. Case 2 was a 66-year-old woman with poorly controlled diabetes mellitus who was found unconscious after a suspected insulin overdose. Examination showed altered mental status and neuroimaging was remarkable for cortical/striatal hyperintensities suggestive of sCJD. On autopsy, she had hypoglycemic/hypoxic nerve cell loss. Although characteristic MRI findings have high sensitivity and specificity for sCJD, potentially reversible metabolic disorders sometimes present rapidly and can resemble sCJD both clinically and radiologically. These cases highlight the importance of establishing a broad differential diagnosis when evaluating a patient with suspected sCJD. PMID:26137419

  4. Spontaneous carotid-cavernous fistula: challenges in clinical and radiologic diagnosis.

    PubMed

    Sobin, Lindsay; Jones, Kristin; Tatum, Sherard

    2014-06-01

    We present a 47-year-old female patient with spontaneous carotid-cavernous fistula without comorbidities. The symptoms of a carotid-cavernous fistula may be confused with other pathology in the region of the orbit and cavernous sinus such as cavernous sinus thrombosis. Carotid-cavernous fistulas most commonly result from direct injury to the internal carotid artery, as with skull base or surgical trauma, but it can also result from weakness in the arterial wall, as with an aneurysm. Because of the high flow of the internal carotid artery, carotid-cavernous fistulas typically present with rapidly progressive symptoms. The case study presented demonstrates the usefulness of radiologic studies in distinguishing between these similarly presenting disease processes. Clinically, cavernous sinus thrombosis generally presents bilaterally and carotid-cavernous fistula presents unilaterally; however, there are a number of exceptions in the literature. The use of a variety of radiologic and angiographic studies will help differentiate between these pathologies. On magnetic resonance imaging, both pathologies can appear as an enlargement of cavernous sinus. Magnetic resonance angiography sequence can reveal aneurysms communicating with the cavernous sinus, and magnetic resonance venography will define thrombosis within the cavernous sinus. Differentiating between cavernous sinus thrombosis and carotid-cavernous fistula can be clinically difficult, and a team approach including emergency physicians, neurosurgeons, ophthalmologists, and otolaryngologists will be called upon to assist in diagnosis. Prompt diagnosis and management can allow for potentially vision and lifesaving interventions. PMID:24656959

  5. Clinical, radiological and molecular diagnosis correlation in serum samples from patients with osteoarticular tuberculosis

    PubMed Central

    García-Elorriaga, Guadalupe; Martínez-Elizondo, Olga; del Rey-Pineda, Guillermo; González-Bonilla, César

    2014-01-01

    Objective To assess the role of polymerase chain reaction (PCR) in serum samples, in the diagnosis of osteoarticular tuberculosis (OTB) in a setting where only clinical and imaging diagnoses determine the treatment. Methods A total of 44 consecutive serum specimens were collected from clinically suspected OTB patients, based on clinical and radiological [X-ray or magnetic resonance imaging/computed tomography] features. They were screened by in-house nested PCR. In addition, a few specimens were examined by Gram stain, acid-fast bacilli stain, histopathology and routine bacterial culture. A total of 39 specimens were collected from patients suffering from other bone diseases of nontuberculous origin and included as negative controls. Results Of the 44 clinically suspected OTB patients, in-house nested PCR was positive in 40 (91%) cases; PCR was negative in 38 (97%) negative controls. Sensitivity and specificity of our in-house nested PCR was 90.9% and 97.4%, respectively. The PCR report was available within 48 h. It was possible to standardize serum PCR technique and in positive cases, a good correlation was observed in terms of an adequate treatment response. Conclusions Nested PCR in serum samples is a rapid, highly sensitive and specific modality for OTB detection. PCR should be performed in addition to clinical evaluation, imaging studies, acid-fast bacilli staining, culture and histopathology diagnosis, if possible. PMID:25183281

  6. Clinical and Radiological Comparison between Ipsilateral and Contralateral Side Canal Decompression Using an Unilateral Laminotomy Approach

    PubMed Central

    Park, Woong Bae; Lee, Sang Won; Sung, Jae Hoon; Yang, Seung Ho; Kim, IL Sub

    2016-01-01

    Objective To compare the clinical and radiological outcome of both sides using the unilateral approach. Methods Unilateral laminotomy was performed to achieve bilateral decompression. Thirty-nine patients who underwent this procedure were analyzed prospectively using the Oswestry Disability Index (ODI), the visual analog scale (VAS) pain score to evaluate symptoms in both legs, and the radiological morphometric index to calculate the anteriorposterior diameter and midcanal width. The incidence of complications from this approach was then evaluated. Results The mean follow-up time was 12.2 months. The mean ODI was 48.4 preoperatively and 14.2 postoperatively. The mean dural sac widening of the ipsilateral side (187.0%) was significantly larger (p<0.01) than that of the the contralateral side (145.6%). The VAS improvement ratio ([preoperative VAS score-postoperative VAS score]/[preoperative VAS score]×100) for the pain in each leg was 75.4%(ipsilateral side) and 73.7%(contralateral side). While the VAS improvement ratio for pain in each side was significantly reduced, the difference in the VAS ratio between sides was statistically insignificant (p=0.64). There were 2 cases (5.1%) of dural tearing during the procedure, 1 case (2.6%) of transient paresthesia of nerve roots, and 2 cases (5.1%) of transient paresthesia of the contralateral nerve root. The transient paresthesias of nerve roots never lasted more than 2 weeks. Conclusion This technique allows for significant decompression of the contralateral canal and excellent clinical outcomes without troublesome complications. Although ipsilateral the dural sac widening was significantly larger than contralateral side, the difference in the clinical outcome between sides was statistically insignificant. PMID:27437011

  7. Intermediate clinical and radiological results of cervical TDR (Mobi-C®) with up to 2 years of follow-up

    PubMed Central

    Beaurain, J.; Bernard, P.; Dufour, T.; Fuentes, J. M.; Hovorka, I.; Huppert, J.; Steib, J. P.; Vital, J. M.; Aubourg, L.

    2009-01-01

    The interest in cervical total disc replacement (TDR) as an alternative to the so-far gold standard in the surgical treatment of degenerative disc disease (DDD), e.g anterior cervical discectomy and fusion (ACDF), is growing very rapidly. Many authors have established the fact that ACDF may result in progressive degeneration in adjacent segments. On the contrary, but still theoretically, preservation of motion with TDR at the surgically treated level may potentially reduce the occurrence of adjacent-level degeneration (ALD). The authors report the intermediate results of an undergoing multicentre prospective study of TDR with Mobi-C® prosthesis. The aim of the study was to assess the safety and efficacy of the device in the treatment of DDD and secondary to evaluate the radiological status of adjacent levels and the occurrence of ossifications, at 2-year follow-up (FU). 76 patients have performed their 2-year FU visit and have been analyzed clinically and radiologically. Clinical outcomes (NDI, VAS, SF-36) and ROM measurements were analyzed pre-operatively and at the different post-operative time-points. Complications and re-operations were also assessed. Occurrences of heterotopic ossifications (HOs) and of adjacent disc degeneration radiographic changes have been analyzed from 2-year FU X-rays. The mean NDI and VAS scores for arm and neck are reduced significantly at each post-operative time-point compared to pre-operative condition. Motion is preserved over the time at index levels (mean ROM = 9° at 2 years) and 85.5% of the segments are mobile at 2 years. HOs are responsible for the fusion of 6/76 levels at 2 years. However, presence of HO does not alter the clinical outcomes. The occurrence rate of radiological signs of ALD is very low at 2 years (9.1%). There has been no subsidence, no expulsion and no sub-luxation of the implant. Finally, after 2 years, 91% of the patients assume that they would undergo the procedure again. These intermediate

  8. The Evaluation of the Clinical, Laboratory, and Radiological Findings of 16 Cases of Brucellar Spondylitis

    PubMed Central

    Yang, Baohui; Hu, Hongbo; Chen, Jie; He, Xijing

    2016-01-01

    Objective. To evaluate the clinical, laboratory, and radiological presentation of 16 cases of brucellar spondylitis. Methods. The clinical manifestations, laboratory tests, and imaging findings of 16 patients (aged from 24 to 66 years) with brucellar spondylitis treated between September 2012 and September 2014 at the Second Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) were retrospectively analyzed. Results. Clinical manifestations included high fever, severe pain, sweating, and fatigue. One patient had epididymitis, and two showed clear signs of spinal nerve damage. Laboratory tests showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein content. Serum brucella agglutination tests were positive, and 11 brucella blood cultures were positive. Imaging manifestations mainly consisted of abnormal signals in the intervertebral space or abnormal signals in the adjacent vertebral bodies (16/16, 100%) in magnetic resonance imaging (MRI), disc space narrowing (14/16, 88%) in X-ray and MRI, or bone destruction and sclerosis around the damaged zone (13/16, 81%) in computed tomography, with rare cases of psoas abscess (2/16, 13%) and sequestrum (1/16, 6%). Conclusion. Since brucellar spondylitis exhibited characteristic clinical and imaging manifestations, it could be diagnosed with specific laboratory tests. Early MRI examination of suspected cases could improve rapid diagnosis. PMID:27672661

  9. The Evaluation of the Clinical, Laboratory, and Radiological Findings of 16 Cases of Brucellar Spondylitis

    PubMed Central

    Yang, Baohui; Hu, Hongbo; Chen, Jie; He, Xijing

    2016-01-01

    Objective. To evaluate the clinical, laboratory, and radiological presentation of 16 cases of brucellar spondylitis. Methods. The clinical manifestations, laboratory tests, and imaging findings of 16 patients (aged from 24 to 66 years) with brucellar spondylitis treated between September 2012 and September 2014 at the Second Affiliated Hospital of Xi'an Jiaotong University (Xi'an, China) were retrospectively analyzed. Results. Clinical manifestations included high fever, severe pain, sweating, and fatigue. One patient had epididymitis, and two showed clear signs of spinal nerve damage. Laboratory tests showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein content. Serum brucella agglutination tests were positive, and 11 brucella blood cultures were positive. Imaging manifestations mainly consisted of abnormal signals in the intervertebral space or abnormal signals in the adjacent vertebral bodies (16/16, 100%) in magnetic resonance imaging (MRI), disc space narrowing (14/16, 88%) in X-ray and MRI, or bone destruction and sclerosis around the damaged zone (13/16, 81%) in computed tomography, with rare cases of psoas abscess (2/16, 13%) and sequestrum (1/16, 6%). Conclusion. Since brucellar spondylitis exhibited characteristic clinical and imaging manifestations, it could be diagnosed with specific laboratory tests. Early MRI examination of suspected cases could improve rapid diagnosis.

  10. Attitudes of Radiologic Science Students, Technologists, and Clinical Instructors Regarding Their Experiential Learning and Career Capacity

    ERIC Educational Resources Information Center

    Burns, Caroline

    2012-01-01

    Radiologic science is an essential part of the healthcare continuum and preparing radiologic science students with experiential learning is essential. It is from this experience working with the patient that students begin to prepare for entry-level practice. The purpose of the study was to examine the attitudes of current radiologic science…

  11. [A new type of sialidosis with kidney disease: nephrosialidosis. I. Clinical, radiological and nosological study].

    PubMed

    Maroteaux, P; Humbel, R; Strecker, G; Michalski, J C; Mande, R

    1978-10-01

    The term nephrosialidosis is proposed to describe a type of oligosaccharidosis in which a glomerular nephropathy develops early and causes death in the early years of life. The clinical and radiological features of the disease are dysmorphic facies, visceral storage disease, early and severe mental retardation and skeletal abnormalities of a type often described in this group of diseases. Foam cells were present in the marrow and, late in the illness, a cherry red spot was present on fundoscopy. The condition is inherited as an autosomal recessive. The leucocytes were deficient in alpha-(2-6) neuraminidase, an abnormality that has also been described in mucolipidosis type I and in other conditions quite distinct from nephrosialidosis. Thus the conditions characterised by this enzyme deficiency are definitely heterogeneous. PMID:747492

  12. Differential Diagnoses of Overgrowth Syndromes: The Most Important Clinical and Radiological Disease Manifestations

    PubMed Central

    Lacerda, Letícia da Silva; Alves, Úrsula David; Zanier, José Fernando Cardona; Machado, Dequitier Carvalho; Camilo, Gustavo Bittencourt; Lopes, Agnaldo José

    2014-01-01

    Overgrowth syndromes comprise a heterogeneous group of diseases that are characterized by excessive tissue development. Some of these syndromes may be associated with dysfunction in the receptor tyrosine kinase (RTK)/PI3K/AKT pathway, which results in an increased expression of the insulin receptor. In the current review, four overgrowth syndromes were characterized (Proteus syndrome, Klippel-Trenaunay-Weber syndrome, Madelung's disease, and neurofibromatosis type I) and illustrated using cases from our institution. Because these syndromes have overlapping clinical manifestations and have no established genetic tests for their diagnosis, radiological methods are important contributors to the diagnosis of many of these syndromes. The correlation of genetic discoveries and molecular pathways that may contribute to the phenotypic expression is also of interest, as this may lead to potential therapeutic interventions. PMID:25009745

  13. [Clinical and radiological assessment of proximally coated stems in growth in total hip replacement].

    PubMed

    Blacha, J; Bednarek, A; Gagała, J

    1998-01-01

    Clinical and radiological results of total hip replacement with proximally coated stems are discussed. Material included 90 hips (50 ABG stems, 40 Level III stems) in 83 patients (59 females, 24 males), mean age 48 years (range 17-22) and mean follow-up of 27 months (range 1-5 years). No stems were revised, the average Harris Hip Score at last follow-up ranged from 89 to 91 points. Stress transfer around the proximal part of the stem resulted in endosteal osteogenesis in the 2nd and 6th Gruen zones and changed trabecular orientation. There was no evidence of bone resorption due to stress shielding. Peri- and endosteal bone reaction in the 3rd and 5th Gruen zones need longer follow-up.

  14. RESULTS FROM CLINICAL AND RADIOLOGICAL FOLLOW-UP, AFTER SURGICAL TREATMENT OF CHONDROBLASTOMA

    PubMed Central

    Penna, Valter; Toller, Eduardo Areas; Ferreira, Adriano Jander; Dias, Dante Palloni Costa

    2015-01-01

    Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. Results: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75%), followed by the proximal tibial epiphysis (16.6%) and the calcaneus (8.4%). There was higher prevalence among the female patients than among the male patients (3:1). In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. Conclusion: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results. PMID:27027054

  15. Characterization of optically stimulated luminescence dosemeters to measure organ doses in diagnostic radiology

    PubMed Central

    Endo, A; Katoh, T; Kobayashi, I; Joshi, R; Sur, J; Okano, T

    2012-01-01

    Objective The aim of this study was to assess the characteristics of an optically stimulated luminescence dosemeter (OSLD) for use in diagnostic radiology and to apply the OSLD in measuring the organ doses by panoramic radiography. Methods The dose linearity, energy dependency and angular dependency of aluminium oxide-based OSLDs were examined using an X-ray generator to simulate various exposure settings in diagnostic radiology. The organ doses were then measured by inserting the dosemeters into an anthropomorphic phantom while using three panoramic machines. Results The dosemeters demonstrated consistent dose linearity (coefficient of variation<1.5%) and no significant energy dependency (coefficient of variation<1.5%) under the applied exposure conditions. They also exhibited negligible angular dependency (≤10%). The organ doses of the X-ray as a result of panoramic imaging by three machines were calculated using the dosemeters. Conclusion OSLDs can be utilized to measure the organ doses in diagnostic radiology. The availability of these dosemeters in strip form proves to be reliably advantageous. PMID:22116136

  16. Infantile hemangioendothelioma of the liver: a radiologic-pathologic-clinical correlation

    SciTech Connect

    Dachman, A.H.; Lichtenstein, J.E.; Friedman, A.C.; Hartman, D.S.

    1983-06-01

    Infantile hemangioendothelioma is the most common symptomatic vascular liver tumor of infancy. It is considered a benign tumor; however, aggressive behavior is occasionally seen microscopically, and rarely distant metastases have been reported. The exact incidence of infantile hemangioendothelioma is difficult to determine because often it has been either misdiagnosed or mislabeled as cavernous hemangioma in the literature. Cavernous hemangioma is the most common primary liver tumor in older age groups but is rarely found in infants as a clinically significant tumor. Levick and Rubie were the first to recognize an association between hemangioendothelioma of the liver and congestive heart failure, and there were subsequent reports substantiating this association. However, it is our impression and the finding of others that congestive heart failure is distinctly less common than abdominal mass or hepatomegaly as the presenting sign in infantile hemangioendothelioma. Congestive heart failure is rarely a feature of cavernous hemangioma. Because of the errors in terminology and questions regarding clinical presentation, a radiologic-pathologic-clinical correlation study of infantile hemangioendothelioma and review of the literature was undertaken.

  17. Clinical and radiological outcomes of surgical treatment for symptomatic arachnoid cysts in adults.

    PubMed

    Wang, Yongqian; Wang, Fei; Yu, Mingkun; Wang, Weiping

    2015-09-01

    We retrospectively analyzed 63 patients (31 males and 32 females) with arachnoid cysts managed over a 15 year period at our institution. Surgical indications and modalities for the treatment of intracranial arachnoid cysts are controversial, although endoscopic fenestration is often recommended as a standard procedure. In our cohort, clinical postoperative results and radiological assessments based on the presenting symptoms, cyst location, cyst volume and surgical modalities were recorded. The most common symptoms included headaches (66.7%), dizziness (46%) and seizures (36.5%). Cyst wall excision with microsurgical craniotomy was carried out in 28 patients (44.4%), cyst fenestration in 16 (25.4%), cystoperitoneal or ventriculoperitoneal shunting in 15 (23.8%) and endoscopic fenestration in four patients (6.3%). A satisfactory clinical outcome was achieved in 51 patients (80.9%) and cyst reduction was achieved in 49 (77.8%), at the last follow-up. Clinical improvement correlated significantly with volume reduction in patients with suprasellar and infratentorial cysts (r=0.495; p=0.022) while a similar result was not found after surgery in patients with frontal and temporal cysts. Surgical complications were not correlated with surgical modalities, occurring in only seven patients (11.1%). The various surgical modalities did not influence outcomes. Patients with nonspecific symptoms such as headache may obtain favourable outcomes from surgical treatment with no severe complications, although, intracranial hypertension and neurological deficits are more definite surgical indications for arachnoid cysts.

  18. Enchondroma versus Low-Grade Chondrosarcoma in Appendicular Skeleton: Clinical and Radiological Criteria

    PubMed Central

    Ferrer-Santacreu, Eugenio M.; Ortiz-Cruz, Eduardo J.; González-López, José Manuel; Pérez Fernández, Elia

    2012-01-01

    Objectives. To determine the validity of clinical and radiological features of enchondroma and low grade chondrosarcoma, and contrast the biopsy results with the clinical diagnosis based on the history and imaging. Material and Method. The study included 96 patients with cartilage type lesions suggestive of an enchondroma (E) or an low grade chondrosarcoma (LGC) according to the clinical and imaging data. The hypotheses were contrasted with the biopsy. Results. Of the 82 patients studied completely, 56 were considered E (68.29%), 8 as LGC (8.33%) and in 18 (18.75%) were doubtful cases and considered as suspected LGC. Of these, the biopsy showed 4 E (25%), 10 LGC (50%) and 4 were not definitive. On the other hand, of the 56 cases diagnosed as E, 15 were biopsied, 5 of these biopsies turned out to be LGC (33.3%). The 8 cases diagnosed as LGC, were also biopsied and only 4 biopsies (50%) confirmed the initial diagnosis. Features analyzed in the study showed no statistically significant difference. Correlation analysis between the diagnosis issued initially and the biopsy result gave a value of 0.69 (kappa coefficient), which was considered a good correlation. Conclusion. Features analyzed did not have any statistical significance. However, there was a good correlation between initial diagnosis and biopsy's result. PMID:22593766

  19. Lack of radiological and clinical benefit over two years of low dose prednisolone for rheumatoid arthritis: results of a randomised controlled trial

    PubMed Central

    Capell, H; Madhok, R; Hunter, J; Porter, D; Morrison, E; Larkin, J; Thomson, E; Hampson, R; Poon, F

    2004-01-01

    Background: Evidence for disease modifying activity of low dose corticosteroid treatment in rheumatoid arthritis is contradictory. Studies showing radiological benefit suggest that continued treatment is required to sustain the effect. Objective: To evaluate the effect of low dose oral prednisolone in early rheumatoid arthritis on disease activity over two years. Design: Double blind placebo controlled trial. Methods: Patients with rheumatoid arthritis, duration <3 years (n = 167), were started on a disease modifying antirheumatic drug (DMARD; sulphasalazine) and allocated by stratified randomisation to prednisolone 7 mg/day or placebo. Primary outcome measure was radiological damage, assessed by the modified Sharp method. Clinical benefit was a secondary outcome. A proactive approach to identifying and treating corticosteroid adverse events was adopted. Patients who discontinued sulphasalazine were offered an alternative DMARD. Results: 90 of 257 patients eligible for the study refused to participate (more women than men). Of those enrolled, 84% were seropositive for rheumatoid factor, median age 56 years, median disease duration 12 months, female to male ratio 1.8:1. Prednisolone was given to 84 patients; of these 73% continued prednisolone and 70% sulphasalazine at 2 years. Of the 83 patients on placebo, 80% continued placebo and 64% sulphasalazine at 2 years. There were no significant differences in radiological score or clinical and laboratory measures at 0 and 2 years. Conclusions: Low dose prednisolone conferred no radiological or clinical benefit on patients maintained on a DMARD over two years. Low dose corticosteroids have no role in the routine management of rheumatoid arthritis treated with conventional disease modifying drugs. PMID:15194574

  20. Experimental measurement of radiological penumbra associated with intermediate energy x-rays (1 MV) and small radiosurgery field sizes

    SciTech Connect

    Keller, Brian M.; Beachey, David J.; Pignol, Jean-Philippe

    2007-10-15

    Stereotactic radiosurgery is used to treat intracranial lesions with a high degree of accuracy. At the present time, x-ray energies at or above Co-60 gamma rays are used. Previous Monte Carlo simulations have demonstrated that intermediate energy x-ray photons or IEPs (defined to be photons in the energy range of 0.2-1.2 MeV), combined with small field sizes, produce a reduced radiological penumbra leading to a sharper dose gradient, improved dose homogeneity and sparing of critical anatomy adjacent to the target volume. This hypothesis is based on the fact that, for small x-ray fields, a dose outside the treatment volume is dictated mainly by the range of electrons set into motion by x-ray photons. The purpose of this work is: (1) to produce intermediate energy x rays using a detuned medical linear accelerator (2) to characterize the energy of this beam (3) to measure the radiological penumbra for IEPs and small fields to compare with that produced by 6 MV x rays or Co-60, and (4) to compare these experimental measurements with Monte Carlo computer simulations. The maximum photon energy of our IEP x-ray spectrum was measured to be 1.2 MeV. Gafchromic EBT films (ISP Technologies, Wayne, NJ) were irradiated and read using a novel digital microscopy imaging system with high spatial resolution. Under identical irradiation conditions the measured radiological penumbra widths (80%-20% distance), for field sizes ranging from 0.3x0.3 to 4.0x4.0 cm{sup 2}, varied from 0.3-0.77 mm (1.2 MV) and from 1.1-2.1 mm (6 MV). Even more dramatic were the differences found when comparing the 90%-10% or the 95%-5% widths, which are in fact more significant in radiotherapy. Monte Carlo simulations agreed well with the experimental findings. The reduction in radiological penumbra could be substantial for specific clinical situations such as in the treatment of an ocular melanoma abutting the macula or for the treatment of functional disorders such as trigeminal neuralgia (a nonlethal

  1. Radiologic Characterization of Ischemic Cholangiopathy in Donation-After-Cardiac-Death Liver Transplants and Correlation With Clinical Outcomes

    PubMed Central

    Giesbrandt, Kirk J.; Bulatao, Ilynn G.; Keaveny, Andrew P.; Nguyen, Justin H.; Paz-Fumagalli, Ricardo; Taner, C. Burcin

    2016-01-01

    OBJECTIVE The purpose of this study was to define the cholangiographic patterns of ischemic cholangiopathy and clinically silent nonanastomotic biliary strictures in donation-after-cardiac-death (DCD) liver grafts in a large single-institution series. We also examined the correlation of the radiologic findings with laboratory data and clinical outcomes. MATERIALS AND METHODS Data were collected for all DCD liver transplants at one institution from December 1998 to December 2011. Posttransplant cholangiograms were obtained during postoperative weeks 1 and 3 and when clinically indicated. Intrahepatic biliary strictures were classified by anatomic distribution and chronologic development. Radiologic findings were correlated with laboratory data and with 1-, 3-, and 5-year graft and patient survival rates. RESULTS A total of 231 patients received DCD grafts. Cholangiograms were available for 184 of these patients. Postoperative cholangiographic findings were correlated with clinical data and divided into the following three groups: A, normal cholangiographic findings with normal laboratory values; B, radiologic abnormalities and cholangiopathy according to laboratory values; and C, radiologic abnormalities without laboratory abnormalities. Group B had four distinct abnormal cholangiographic patterns that were predictive of graft survival. Group C had mild nonprogressive multifocal stenoses and decreased graft and patient survival rates, although cholangiopathy was not detected in these patients according to laboratory data. CONCLUSION Patterns and severity of nonanastomotic biliary abnormalities in DCD liver transplants can be defined radiologically and correlate with clinical outcomes. Postoperative cholangiography can depict the mild biliary abnormalities that occur in a subclinical manner yet cause a marked decrease in graft and patient survival rates in DCD liver transplants. PMID:26496544

  2. Clinical, hormonal and radiological profile of 46XY disorders of sexual development

    PubMed Central

    Vasundhera, Chauhan; Jyotsna, Viveka P.; Kandasamy, Devasenathipathy; Gupta, Nandita

    2016-01-01

    Background and Objectives: 46 XY disorders of sexual development (DSD) cover a wide spectrum of phenotypes ranging from unambiguous female genitalia to ambiguous male genitalia with hypospadias or dysgenetic gonads. Management of these patients depends on the cause of DSD, degree of feminization, age at presentation, and gender orientation. The aim of this study was to evaluate the presentation and management of patients with 46XY DSD at our center. Patients and Methods: All new and old patients of 46XY DSD attending the endocrine OPD in a period of 16 months were included in this study. Clinical, cytogenetic, hormonal, and radiological evaluation were done to identify the cause of DSD. Results: Among 19 patients, eight were diagnosed with disorders of gonadal development (one with complete gonadal dysgenesis, four with partial gonadal dysgenesis, two with congenital bilateral anorchia, and one with ovotesticular DSD) and eight with disorders of androgen synthesis and action (one with complete androgen insensitivity syndrome [AIS], three with partial AIS and four with 5α reductase deficiency). In three patients, a definitive diagnosis could not be made. Conclusions: Management of patients with DSD depends on etiology, gender assignment, gender orientation, hormonal treatment, genital surgery, and consequent psychosocial implications. Due to the overlapping clinical and biochemical parameters in different subsets of DSD, only a preliminary etiological diagnosis can be made in some cases. Genetic studies with long-term follow-up are required for an accurate diagnosis. PMID:27186544

  3. Clinical Experience With A High Resolution Digital Imaging System For Gastro-Intestinal Radiology

    NASA Astrophysics Data System (ADS)

    Edmonds, E. W.; Rowlands, J. A.; Hynes, D. M.; Toth, B. D.; Porter, A. J.

    1987-01-01

    In our department, it is planned that the gastro-intestinal fluoroscopic area will be equipped entirely with digital imaging systems. The use of the 1024 X 1024 pixel frame store, backed by a hard disc for rapid image transfer, and the production of hard copy on a laser imager has reached the point where clinical efficacy and acceptance are assured. The further addition of facilities for annotation and the application of digital post-processing techniques are being explored both at the clinical site and at the research laboratorieS. The use of laser imaging has produced a further improvement in image quality and some of the practical problems related to this apparatus will be described. The availability of larger capacity laser disc image storage enables the local area network or "mini-PACS" system for fluoroscopy areas to become a concept worthy of investigation. We present our experience over a number of years with these systems, together with our latest investigations into potential applications of laser technology to the practice of radiology in a busy imaging centre.

  4. Diffuse lung uptake (DLU) on Ga-67 scintigraph: Clinical, radiologic and pathologic correlation

    SciTech Connect

    Sy, W.M.; Seo, I.S.; Vieira, J.; Zaman, M.

    1985-05-01

    Review, analysis and correlation (clinical, radiologic and pathologic) of 29 consecutive adults (16 drug addicts and/or homosexuals) with DLU on Ga-67 scintigraph were made. Diffuse increased uptake of at least 75% of both lungs was considered as DLU. WFOF cameras were used to obtain 24 to 96 hr. scintigraphs after IV injection of 3-5 mCi of Ga-67 citrate. In 26, tissue diagnosis established: pneumocystis carinii (PC) 15, miliary tuberculosis (TB) 3, sarcoidosis (SR) 3, drug-induced toxicity 2, and toxoplasmosis (TX), primary hyperparathyroidism and nonspecific lymphocytic pneumonia-one each. In two with breast and one with esophageal carcinomas, no lung tissue diagnosis was sought. Concurrent chest x-rays were negative in 16, but in 7/16, lung infiltrate was later documented. An average of 31 days elapsed before x-rays became positive in four with PC, 7 days in two with TB, and 22 days in one with TX. In 13, concurrent x-rays showed lung infiltrate, but in 6, only subtle, localized rather than diffuse infiltrate was noted. Fourteen of 29 had at least two Ga-67 studies. In 12 (7 PC, 2 TB, 3 SR) of 14 whose repeat studies showed significant to total disappearance of DLU, all did well clinically. In two whose initial studies were negative or equivocal, they became clinically worse when the repeat study showed DLU. In three others (2 PC, 1 TX) who died, their single studies recorded intense DLU. DLU on gallium scintigraph indicated a variety of pathology. In 55.2%, gallium scintigraph predated x-ray findings by a few days to weeks. In 20.3%, x-ray findings were only subtle or localized. Scintigraphic changes correlated well with the clinical courses in various diseases.

  5. To Study the Clinical, Biochemical and Radiological Features of Acute Pancreatitis in HIV and AIDS

    PubMed Central

    Raza, Shahzad; Chaudhry, Naueen A.; Brown, Jordan D.; Aghaie, Sina; Rezai, Damoun; Khan, Areej; Tan, Paul De Leon; Berger, Barbara J.

    2013-01-01

    to 3 days in patients with CD4 > 200. P = 0.03 via t-test comparison. One patient with CD4 < 50 died due to acute pancreatitis. Conclusion Pancreatitis remains a major cause of morbidity in HIV-infected individuals. This study has provided detailed features in the HAART therapy era about the clinical, biochemical and radiological features of pancreatitis. Half of our patients were positive for HCV; additionally, 36% with CD4 < 50 had persistent HBV. As opposed to earlier studies, we did not find a female predominance. Patients with CD4 < 200 had a 2.67-fold increase length of stay. Future studies are needed for a closer look on viral cofactors which might precipitate episodes of acute pancreatitis. PMID:23390470

  6. Liver Masses: A Clinical, Radiological and Pathological Perspective For: Perspectives in Clinical Gastroenterology and Hepatology

    PubMed Central

    Venkatesh, Sudhakar K.; Chandan, Vishal; Roberts, Lewis R.

    2013-01-01

    Liver masses present a relatively common clinical dilemma, particularly with the increasing use of various imaging modalities in the diagnosis of abdominal and other symptoms. The accurate and reliable determination of the nature of the liver mass is critical, not only to reassure individuals with benign lesions but also, and perhaps more importantly, to ensure that malignant lesions are diagnosed correctly. This avoids the devastating consequences of missed diagnosis and the delayed treatment of malignancy or the unnecessary treatment of benign lesions With appropriate interpretation of the clinical history and physical examination, and the judicious use of laboratory and imaging studies, the majority of liver masses can be characterized noninvasively. Accurate characterization of liver masses by cross-sectional imaging is particularly dependent on an understanding of the unique phasic vascular perfusion of the liver and the characteristic behaviors of different lesions during multiphasic contrast imaging. When non-invasive characterization is indeterminate, a liver biopsy may be necessary for definitive diagnosis. Standard histologic examination is usually complemented by immunohistochemical analysis of protein biomarkers. Accurate diagnosis allows the appropriate selection of optimal management, which is frequently reassurance or intermittent follow up for benign masses. For malignant lesions or those at risk of malignant transformation, management depends on the tumor staging, the functional status of the uninvolved liver and technical surgical considerations. Unresectable metastatic masses require oncologic consultation and therapy. The efficient characterization and management of liver masses therefore requires a multidisciplinary collaboration between the gastroenterologist/hepatologist, radiologist, pathologist, hepatobiliary or transplant surgeon, and medical oncologist. PMID:24055987

  7. Rigid Bronchoscopy in Airway Foreign Bodies: Value of the Clinical and Radiological Signs

    PubMed Central

    Acharya, Kunjan

    2016-01-01

    Introduction  Foreign body in airway is a common emergency in ENT practice. As we know, Rigid Bronchoscopy is the method of choice for removing it, although at times it leads to specialists performing unnecessary bronchoscopy, exposing patients to hazards of general anesthesia. Objective  The objective of my study is to calculate sensitivity, specificity, positive predictive value, odds ratio from the clinical and radiological signs, comparing with the gold standard, the rigid bronchoscope procedure. Method  This is a prospective analytical study designed at University Teaching Hospital and conducted over a period of 18 months, from March 2011 to August 2012. Data collection was broadly classified into three different categories: (1) Symptomatology, such as presence or absence of choking, cyanosis, and difficulty in breathing; (2) Clinical signs, such as the presence or absence of air entry, crackles, and rhonchi 3. Chest X-ray findings were suggestive of a foreign body. Results  There were a total of 40 rigid bronchoscopies performed under general anesthesia for the diagnosis and therapeutic reasons. Among 40 patients who underwent rigid bronchoscopy, 32 (80%) were found to have varieties of foreign bodies in their airway while 8 patients (20%) had negative bronchoscopy. The history of choking is the only clinical symptoms which came out to be statistically Significant (p = 0.043) with odds ratio of 5. Conclusion  Rigid bronchoscopy is the gold standard technique for diagnosis and procedure of choice to remove FB from airway. Regardless, it still presents a small chance of negative result, especially when there is no history of aspiration. PMID:27413398

  8. CLINICAL AND RADIOLOGICAL EVALUATION ON DEVELOPMENTAL HIP DYSPLASIA AFTER SALTER AND OMBRÉDANNE PROCEDURE

    PubMed Central

    da Rocha, Válney Luiz; Thomé, André Luiz Coelho; da Silva Castro, Daniel Labres; de Oliveira, Leandro Zica; de Moraes, Frederico Barra

    2015-01-01

    Objective: To evaluate the clinical and radiological medium-term results from surgical treatment of developmental hip dysplasia through Salter innominate bone osteotomy and Ombrédanne femoral shortening. Methods: Fourteen patients were evaluated, with surgical treatment on 18 hips (seven right-side hips and eleven left-side hips) using the proposal technique, performed between 1998 and 2008. The Dutoit and Severin criteria were used respectively for clinical and radiographic evaluations. Results: The average preoperative index for the seven right-side hips was 43.3° (40° to 50°), and this was corrected through surgery to an average of 31.57° (24° to 42°). The average preoperative index for the eleven left-side hips was 42.1° (36° to 56°), and this was corrected through surgery to an average of 30.36° (20° to 44°). There was a statistically significant difference between the preoperative and postoperative acetabular indexes, with P > 0.05. The clinical evaluation showed that there were seven excellent hips (38.9%), eight good ones (44.4%), three fair hips (16.7%) and no poor ones (0%). By grouping the hips rated good and excellent as satisfactory and those rated poor and fair as unsatisfactory, 83.3% of the results were seen to be favorable. There were no statistically significant correlations between occurrences of complications and patient age at the time of surgery or between complications and the preoperative acetabular index (p > 0.05). The complications observed consisted of one case each of subluxation, osteonecrosis and osteonecrosis together with subluxation. Conclusion: The combined procedure of Salter and Ombrédanne is a viable option for treating developmental hip dysplasia after patients have started to walk. PMID:27027068

  9. Clinical and radiological assessment of effects of long-term corticosteroid therapy on oral health

    PubMed Central

    Beeraka, Swapna Sridevi; Natarajan, Kannan; Patil, Rajendra; Manne, Rakesh Kumar; Prathi, Venkata Sarath; Kolaparthi, Venkata Suneel Kumar

    2013-01-01

    Background: Corticosteroids (Cs) are used widely for their anti-inflammatory and immunosuppressive properties. They have the potential to cause dramatic improvement as well as produce equally dramatic adverse effects. The clinical misuse like over prescription of the drug should be avoided. Long-term administration may cause many adverse effects leading to impaired oral health. Oral health is usually not considered during management of patients on long-term corticosteroid therapy. The aim of this study was to assess the oral health status and radiological changes in the jaw bones of the patients under long-term corticosteroid therapy. Materials and Methods: Oral health of 100 patients under long-term corticosteroid therapy with a minimum of 3 months duration was compared with sex- and age-matched 100 healthy controls. The clinical examination included complete examination of the mouth and periodontal status. Radiographic evaluation of bone with the help of intra oral periapical radiograph and digital orthopantomograph and levels of serum calcium, alkaline phosphatase, and random blood sugar were assessed. ‘Chi-square test’, ‘Kolmogorov-Smirnov test’ and ‘Mann-Whitney U test’ were used for statistical analysis. P > 0.05 was considered significant. Results: Patients on steroids exhibited significantly higher levels of candidiasis and clinical attachment loss of the periodontal ligament, probing pocket depth. Bone density was significantly lower in the study group than that in the control group. Random blood glucose was significantly higher and significant lower levels of calcium were observed in patients on steroids. Conclusion: Long-term use of Cs may affect oral health adversely leading to candidiasis as well as impair bone metabolism leading to a considerable decrease in the mandibular bone mineral density. PMID:24348627

  10. Advanced hepatocellular carcinoma and sorafenib: Diagnosis, indications, clinical and radiological follow-up.

    PubMed

    Colagrande, Stefano; Regini, Francesco; Taliani, Gian Giacomo; Nardi, Cosimo; Inghilesi, Andrea Lorenzo

    2015-05-18

    Advanced stage hepatocellular carcinoma (HCC) is a category of disease defined by radiological, clinical and hepatic function parameters, comprehending a wide range of patients with different general conditions. The main therapeutic option is represented by sorafenib treatment, a multi-kinase inhibitor with anti-proliferative and anti-angiogenic effect. Trans-arterial Radio Embolization also represents a promising new approach to intermediate/advanced HCC. Post-marketing clinical studies showed that only a portion of patients actually benefits from sorafenib treatment, and an even smaller percentage of patients treated shows partial/complete response on follow-up examinations, up against relevant costs and an incidence of drug related adverse effects. Although the treatment with sorafenib has shown a significant increase in mean overall survival in different studies, only a part of patients actually shows real benefits, while the incidence of drug related significant adverse effects and the economic costs are relatively high. Moreover, only a small percentage of patients also shows a response in terms of lesion dimensions reduction. Being able to properly differentiate patients who are responding to the therapy from non-responders as early as possible is then still difficult and could be a pivotal challenge for the future; in fact it could spare several patients a therapy often difficult to bear, directing them to other second line treatments (many of which are at the moment still under investigation). For this reason, some supplemental criteria to be added to the standard modified Response Evaluation Criteria in Solid Tumors evaluation are being searched for. In particular, finding some parameters (cellular density, perfusion grade and enhancement rate) able to predict the sensitivity of the lesions to anti-angiogenic agents could help in stratifying patients in terms of treatment responsiveness before the beginning of the therapy itself, or in the first weeks of

  11. Clinical and Radiological Evaluation after Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique

    PubMed Central

    Lee, Kwang Won; Bae, Kyoung Wan; Choy, Won Sik

    2013-01-01

    Background We retrospectively assessed the clinical outcomes and investigated risk factors influencing retear after arthroscopic suture bridge repair technique for rotator cuff tear through clinical assessment and magnetic resonance arthrography (MRA). Methods Between January 2008 and April 2011, sixty-two cases of full-thickness rotator cuff tear were treated with arthroscopic suture bridge repair technique and follow-up MRA were performed. The mean age was 56.1 years, and mean follow-up period was 27.4 months. Clinical and functional outcomes were assessed using range of motion, Korean shoulder score, Constant score, and UCLA score. Radiological outcome was evaluated with preoperative and follow-up MRA. Potential predictive factors that influenced cuff retear, such as age, gender, geometric patterns of tear, size of cuff tear, acromioplasty, fatty degeneration, atrophy of cuff muscle, retraction of supraspinatus, involved muscles of cuff and osteolysis around the suture anchor were evaluated. Results Thirty cases (48.4%) revealed retear on MRA. In univariable analysis, retear was significantly more frequent in over 60 years age group (62.5%) than under 60 years age group (39.5%; p = 0.043), and also in medium to large-sized tear than small-sized tear (p = 0.003). There was significant difference in geometric pattern of tear (p = 0.015). In multivariable analysis, only age (p = 0.036) and size of tear (p = 0.030) revealed a significant difference. The mean active range of motion for forward flexion, abduction, external rotation at the side and internal rotation at the side were significantly improved at follow-up (p < 0.05). The mean Korean shoulder score, Constant score, and UCLA score increased significantly at follow-up (p < 0.01). The range of motion, Korean shoulder score, Constant score, and UCLA score did not differ significantly between the groups with retear and intact repairs (p > 0.05). The locations of retear were insertion site in 10 cases (33.3%) and

  12. Tubercular meningitis in children: Clinical, pathological, and radiological profile and factors associated with mortality

    PubMed Central

    Israni, Anil V.; Dave, Divya A.; Mandal, Anirban; Singh, Amitabh; Sahi, Puneet K.; Das, Rashmi Ranjan; Shah, Arpita

    2016-01-01

    Context: Childhood tuberculosis is a major public health problem in developing countries with tubercular meningitis being a serious complication with high mortality and morbidity. Aim: To study the clinicopathological as well as radiological profile of childhood tuberculous meningitis (TBM) cases. Settings and Design: Prospective, observational study including children <14 years of age with TBM admitted in a tertiary care hospital from Western India. Subjects and Methods: TBM was diagnosed based on predefined criteria. Glassgow coma scale (GCS) and intracranial pressure (ICP) was recorded. Staging was done as per British Medical Council Staging System. Mantoux test, chest X-ray, cerebrospinal fluid (CSF) examination, neuroimaging, and other investigations were done to confirm TB. Statistical Analysis Used: STATA software (version 9.0) was used for data analysis. Various risk factors were determined using Chi-square tests, and a P< 0.05 was considered significant. Results: Forty-seven children were included, of which 11 (24.3%) died. Fever was the most common presenting symptom, and meningismus was the most common sign. Twenty-nine (62%) children presented with Stage III disease. Stage III disease, low GCS, and raised ICP were predictors of mortality. Findings on neuroimaging or CSF examination did not predict mortality. Conclusions: Childhood TBM presents with nonspecific clinical features. Stage III disease, low GCS, lack of Bacillus Calmette–Guérin vaccination at birth and raised ICP seem to the most important adverse prognostic factors. PMID:27365958

  13. [Clinical and radiologic evaluation of a polylactic acid interposition arthroplasty after trapezectomy].

    PubMed

    Guinet, V; Mure, J-P; Vimont, E

    2013-06-01

    Surgical management of trapeziometacarpal osteoarthritis does not obey to strict rules. The use of interposition implants made of different materials leads to enrichment of surgeon's resources. This prospective study reports the radiological and clinical results of 45 patients treated by total trapeziectomy with polylactic acid interposition implant, with an average follow-up of 31 months. Thirty-seven surgical treatments were carried out after ineffective medical treatment. According to Dell classification, there were five stages II, 30 stages III and two stages IV. Mean age was 66 years. Dominant side was involved in 60%. Thumbs were pain free at 5 months in average and 81% of the patients reported good results (Alnot stages 0 and 1). The average opposition was 9.1/10, the average M1M2 angle was 40°, and the average key pinch strength was 4.4 kg. Six patients suffered from sympathetic dystrophy but neither infection nor local inflammatory reaction was observed. Collapse of the trapezium space was constant and the trapezium space ratio was 76% at the follow-up. Seventy-five per cent of patients returned back to their occupation. The satisfaction rate was 89%. The radioclinical results were very good in our series. The interposition of polylactic acid implant permits to avoid the presumed complications of tendon harvesting, and those of other types of material used in the same indication. Its safety seems excellent.

  14. Infantile hepatic hemangiomas. Clinical features, radiologic investigations, and treatment of 20 patients

    SciTech Connect

    Stanley, P.; Geer, G.D.; Miller, J.H.; Gilsanz, V.; Landing, B.H.; Boechat, I.M. )

    1989-08-15

    The clinical features, radiologic investigation, and treatment of 20 infants with hepatic hemangiomas are presented. Palpable abdominal mass (n = 18) and cardiac failure (n = 11) were the common presenting features. Nine patients had hyperconsumptive coagulopathy. Seven patients had other hemangiomas. Ultrasound (n = 15) showed the number and distribution of the hemangiomas within the liver. Hypoechoic and hyperechoic elements were present in addition to prominent vascular channels and diminished caliber of the distal aorta. Radionuclide sulfur colloid (n = 12) and labeled red blood cell (n = 7) studies showed the distribution and vascularity of the hemangiomas. Computed tomography (n = 8) revealed central hypointensity with marked peripheral enhancement after contrast. Arteriography now performed only as a prelude to therapeutic embolization demonstrated hypervascularity in each patient, contrast pooling in six and early draining veins in five. Magnetic resonance scanning (n = 3) showed decreased signal intensity on T1 images and high intensity signal on T2. In two patients, there was resolution or improvement of the hemangiomas without therapy. Four patients had surgery (lobectomy (2), trisegmentectomy (1), and surgical evacuation of a central hematoma (1)). Steroids and radiation were given to seven patients, and one patient also required therapeutic embolization. Steroids were the initial therapy in five patients, one of whom later required therapeutic embolization and another cyclophosphamide. Two patients were treated initially with radiation therapy, one of whom also needed emergency hepatic artery ligation. Seventeen of the 20 patients are alive and well from 6 months to 14 years after diagnosis.

  15. Etiological, clinical, and radiological features of longitudinally extensive myelopathy in Chinese patients.

    PubMed

    Zhang, Weihe; Jiao, Yujuan; Cui, Lei; Liu, Lei; Zhang, Linwei; Jiao, Jinsong

    2016-10-01

    Longitudinally extensive myelopathy (LEM) is a rare spinal syndrome, and was mostly assessed in western populations. In order to investigate the etiological, clinical, and radiological features of LEM in Chinese patients, we retrospectively analyzed eighty-nine (40 men and 49 women, median age 45.9±15.7years) patients with LEM hospitalized in China-Japan Friendship Hospital. LEM comprised autoimmune inflammatory myelitis (n=53), metabolic and compressive disorders (n=13), vascular diseases (n=10), neoplastic diseases (n=7), infectious diseases (n=4), and syringomyelia (n=2). Neuromyelitis optica spectrum disorders (NMOSD) was the most common cause of transverse myelopathy identified in LEM (38/89 [42.7%]) characterized by intractable vomiting and hiccups and painful tonic spasms. Subacute combined degeneration and anterior spinal artery syndrome accounted for the largest non-transverse LEM, which selectively affected the spinal dorsal and/or lateral columns and the spinal anterior region, respectively. Radicular pain was common in anterior spinal artery syndrome. Postrema (n=15, 39.5%) and cervical (n=31, 81.6%) lesions were significantly increased in NMOSD versus non-NMOSD (n=7, 13.7% and n=34, 66.7%, respectively, p<0.05]. Axial T2-weighted MRI indicated that 46 (51.7%) patients exhibited complete lesions; 43 (48.3%) patients exhibited non-transverse lesions, mainly unilateral or symmetrical tract lesions. Twenty-four (51.1%) LEM patients exhibited distinct gadolinium contrast enhancement. In this Chinese cohort, LEM was primarily attributed to NMOSD. While the etiological distribution in the non-NMOSD group was different from western populations, clinical and imaging features may facilitate a differential diagnosis. PMID:27526974

  16. Somatosensory evoked potentials in cervical spondylosis. Correlation of median, ulnar and posterior tibial nerve responses with clinical and radiological findings.

    PubMed

    Yu, Y L; Jones, S J

    1985-06-01

    Somatosensory evoked potentials (SEPs) following median, ulnar and tibial nerve stimulation were recorded from sites over the shoulders, neck and scalp in 34 patients with cervical spondylosis. Twenty control subjects were matched for sex and age. Detailed clinical and radiological data were assembled, with particular attention to the sensory modalities impaired and the locus and severity of cord compression. The patients were divided clinically into 4 groups: combined myelopathy and radiculopathy (6 cases), myelopathy alone (15), radiculopathy (6) and neck pain (7). Four cases are described in detail. SEP abnormalities were strongly correlated with clinical myelopathy, but not with radiculopathy. Median and ulnar nerve responses were less often affected than tibial, even with myelopathy above C6 level. Tibial nerve SEP abnormalities were strongly correlated with posterior column signs on the same side of the body, but not with anterolateral column sensory signs. In myelopathy cases, the SEP examination appeared to be more sensitive to sensory pathway involvement than clinical sensory testing. SEP abnormalities were infrequent in cases of radiculopathy and neck pain, bearing no relation to the clinical locus of root lesions. Abnormal SEPs consistent with subclinical posterior column involvement, however, were recorded in 1 patient with radiculopathy and 2 with neck pain. Follow-up recordings made postoperatively in 7 myelopathy cases reflected the clinical course (improvement, deterioration or no change) in 4, but failed to reflect improvement in 3. The correlation of SEP findings with radiological data was generally poor. SEP abnormalities were detected in 6 out of 8 patients with clinical myelopathy but no radiological evidence of posterior cord compression, suggesting that impairment of the blood supply may be an important factor contributing to cord damage. An application for SEPs in the clinical management of cervical spondylosis may lie in the detection of

  17. Orbital floor reconstruction with poly-L/D-lactide implants: clinical, radiological and immunohistochemical study in sheep.

    PubMed

    Kontio, R; Suuronen, R; Konttinen, Y T; Hallikainen, D; Lindqvist, C; Kommonen, B; Kellomäki, M; Kylmä, T; Virtanen, I; Laine, P

    2004-06-01

    In this study the reconstruction capacity of orbital wall in sheep was evaluated when poly-L/D-lactide (PLDLA96) implants were used for large blow-out defects in 18 sheep. The contralateral side, where the defects healed spontaneously, served as controls. The follow-up was 12, 16, 22 and 36 weeks. Healing was evaluated clinically, radiologically, histologically and immunohistochemically. Physiochemical properties of the implants were also studied. At first, the implants were surrounded by elastic capsules, which gradually ossified. At 36 weeks, 60% were still visible and deformed but surrounded by bone. Light microscopy revealed a low grade inflammatory reaction. Expression of Tn-c and cFn was intense throughout the study. Shear strength decreased gradually and was not measurable after 16 weeks. Crystallinity increased steadily from 1.5 to 29.30% and molecular weight decreased from 49,000 to 4186. In CT, the final bony defect was smaller in the reconstructed sides than in the controls. Based on this study it can be concluded that PLDLA96 implant provokes a local inflammation, which does not prevent bone healing. The deformation of the implant, however, indicates that this PLDLA96 plate is not suitable for orbital floor reconstruction.

  18. Congenital intestinal malrotation in adolescent and adult patients: a 12-year clinical and radiological survey.

    PubMed

    Husberg, Britt; Salehi, Karin; Peters, Trevor; Gunnarsson, Ulf; Michanek, Margareta; Nordenskjöld, Agneta; Strigård, Karin

    2016-01-01

    Congenital intestinal malrotation is mainly detected in childhood and caused by incomplete rotation and fixation of the intestines providing the prerequisites for life-threatening volvulus of the midgut. The objective of this study was to evaluate a large cohort of adult patients with intestinal malrotation. Thirty-nine patients, 15-67 years, were diagnosed and admitted to a university setting with congenital intestinal malrotation 2002-2013. The patients were divided into three age groups for stratified evaluation. Medical charts were scrutinized, and clinical outcome of surgery was reviewed. Twelve patients presented as emergency cases, whereas 27 were admitted as elective cases. Diagnosis was established in 33 patients who underwent radiological investigation and in the remaining 6 during surgery. A Ladd's operation was performed in 31 symptomatic patients; a conservative strategy was chosen in eight cases. Volvulus was more common in the younger age group. Twenty-six surgically treated patients were available for telephone interview, 1-12 years after surgery. All patients, except one, regarded their general condition improved to a high degree (n = 18) or with some reservation (n = 7). Twelve patients suffered remaining abdominal pain of a chronic and diffuse character. Due to recurrence of malrotation six patients were reoperated. Symptomatic malrotation occurs in both children and the adult population. Improved awareness and an accurately performed CT scan can reveal the malformation and enable surgical treatment. A Ladd's procedure relieved most patients from their severe complaints even when a history of several years of suffering existed. PMID:27026938

  19. Clinical and Radiologic Analysis of Posterior Apophyseal Ring Separation Associated with Lumbar Disc Herniation

    PubMed Central

    Bae, Jung-Sik; Rhee, Woo-Tack; Kim, Woo-Jae; Ha, Seong-Il; Lim, Jae-Hyeon

    2013-01-01

    Objective We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. Methods We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. Results PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were 3.6±2.9 and 5.4±6.4 in the unresected PARS group, 5.8±2.1 and 11.3±7.1 in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. Conclusion The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability. PMID:23634263

  20. The pressure exerted on the tracheal wall by two endotracheal tube cuffs: A prospective observational bench-top, clinical and radiological study

    PubMed Central

    2010-01-01

    Background The Lotrach endotracheal tube has a unique low-volume, low-pressure (LVLP) cuff, which has been designed to prevent pressure injury to the tracheal wall. We aimed to estimate the pressure exerted on the tracheal wall by the LVLP cuff and a conventional cuff in a bench-top, clinical and radiological study. Method In the bench-top study, a model trachea was intubated with the LVLP cuff and the conventional cuff. The cuff pressure was controlled using a constant pressure device. We assessed the pressure exerted on the tracheal wall by measuring the ability of the cuffs to support a column of water using a standard protocol. In the clinical study, we tested the ability of both cuffs to prevent air leak during a staged recruitment manoeuvre. In the radiological study, we recorded the degree of anatomical distortion of the trachea from both cuffs in the antero-posterior (AP) and transverse tracheal diameters. We performed statistical analysis using non-inferiority tests. Results In the bench-top study, the LVLP cuff achieved a plateau at a mean height of 25.2 cmH2O (SD 0.34). In contrast, the conventional cuff failed to maintain any water above the cuff and a plateau could not be measured. In the clinical study, the mean pressure at which air leak occurred was 30.0 +/- 0.8 cmH2O (SD 3.8) using the LVLP cuff and 32.4 +/- 0.7 cmH2O (SD 3.0) using the conventional cuff. In the radiological study, the mean degree of anatomical distortion of the trachea in AP and transverse tracheal diameter was 2.9 +/- 2.2 mm (SD 2.1) and 1.8 +/- 1.4 mm (SD 1.4) using the LVLP cuff and 4.4 +/- 1.3 mm (SD 1.4) and 2.6 +/- 1.5 mm (SD 1.6) using the conventional cuff. Conclusions The bench-top and clinical studies both demonstrated that the LVLP cuff exerted approximately 30 cmH2O of pressure on the tracheal wall. These results are supported by our radiological study. We conclude that the LVLP cuff exerts an acceptable amount of pressure on the tracheal wall when it is operated at

  1. Facet joint disturbance induced by miniscrews in plated cervical laminoplasty: Dose it influence the clinical and radiologic outcomes?

    PubMed

    Chen, Hua; Li, Huibo; Wang, Beiyu; Li, Tao; Gong, Quan; Song, Yueming; Liu, Hao

    2016-09-01

    A retrospective cohort study. Plated cervical laminoplasty is an increasingly common technique. A unique facet joint disturbance induced by lateral mass miniscrews penetrating articular surface was noticed. Facet joints are important to maintain cervical spine stability and kinetic balance. Whether this facet joint disturbance could affect clinical and radiologic results is still unknown. The objective of this study is to investigate the clinical and radiologic outcomes of patients with facet joints disturbance induced by miniscrews in plated cervical laminoplasty.A total of 105 patients who underwent cervical laminoplasty with miniplate fixation between May 2010 and February 2014 were comprised. Postoperative CT images were used to identify whether facet joints destroyed by miniscrews. According to facet joints destroyed number, all the patients were divided into: group A (none facet joint destroyed), group B (1-2 facet joints destroyed), and group C (≥3 facet joints destroyed). Clinical data (JOA, VAS, and NDI scores), radiologic data (anteroposterior diameter and Palov ratio), and complications (axial symptoms and C5 palsy) were evaluated and compared among the groups.There were 38, 40, and 27 patients in group A, B, and C, respectively. The overall facet joints destroyed rate was 30.7%. All groups gained significant JOA and NDI scores improvement postoperatively. The preoperative JOA, VAS, NDI scores, and postoperative JOA scores did not differ significantly among the groups. The group C recorded significant higher postoperative VAS scores than group A (P = 0.002) and B (P = 0.014) and had significant higher postoperative NDI scores than group A (P = 0.002). The pre- and postoperative radiologic data were not significant different among the groups. The group C had a significant higher axial symptoms incidence than group A (12/27 vs 8/38, P = 0.041).Facet joints disturbance caused by miniscrews in plated cervical laminoplasty may not influence neurological

  2. [Clinical research=design*measurements*statistical analyses].

    PubMed

    Furukawa, Toshiaki

    2012-06-01

    A clinical study must address true endpoints that matter for the patients and the doctors. A good clinical study starts with a good clinical question. Formulating a clinical question in the form of PECO can sharpen one's original question. In order to perform a good clinical study one must have a knowledge of study design, measurements and statistical analyses: The first is taught by epidemiology, the second by psychometrics and the third by biostatistics.

  3. Guide for radiological characterization and measurements for decommissioning of US Department of Energy surplus facilities

    SciTech Connect

    Denahm, D. H.; Barnes, M. G.; Jaquish, R. E.; Corley, J. P.; Gilbert, R. O.; Hoenes, G. R.; Jamison, J. D.; McMurray, B. J.; Watson, E. C.

    1983-08-01

    This Guide describes the elements of radiological characterization at DOE excess facilities in preparation for, during, and subsequent to decommissioning operations. It is the intent of this Guide and accompanying appendices to provide the reader (user) with sufficient information to carry out that task with a minimum of confusion and to provide a uniform basis for evaluating site conditions and verifying that decommissioning operations are conducted according to a specific plan. Some areas of particular interest in this Guide are: the need to involve appropriate staff from the affected states in the early planning stages of decommissioning; the need for and suggested methods of radiological site characterization to complete a decommissioning project, including: historical surveys, environmental pathway analyses, statistical sampling design, and choosing appropriate instrumentation and measurements; the need for and emphasis on quality assurance, documentation and records retention; the establishment of a Design Objective approach to applying site-specific contamination limits based on the ALARA philosophy; the establishment of a ''de minimis'' or minimum dose level of concern for decommissioning operations based on existing standards, experience and ALARA considerations.

  4. Drug-associated progressive multifocal leukoencephalopathy: a clinical, radiological, and cerebrospinal fluid analysis of 326 cases.

    PubMed

    Maas, Roderick P P W M; Muller-Hansma, Annemarie H G; Esselink, Rianne A J; Murk, Jean-Luc; Warnke, Clemens; Killestein, Joep; Wattjes, Mike P

    2016-10-01

    The implementation of a variety of immunosuppressive therapies has made drug-associated progressive multifocal leukoencephalopathy (PML) an increasingly prevalent clinical entity. The purpose of this study was to investigate its diagnostic characteristics and to determine whether differences herein exist between the multiple sclerosis (MS), neoplasm, post-transplantation, and autoimmune disease subgroups. Reports of possible, probable, and definite PML according to the current diagnostic criteria were obtained by a systematic search of PubMed and the Dutch pharmacovigilance database. Demographic, epidemiologic, clinical, radiological, cerebrospinal fluid (CSF), and histopathological features were extracted from each report and differences were compared between the disease categories. In the 326 identified reports, PML onset occurred on average 29.5 months after drug introduction, varying from 14.2 to 37.8 months in the neoplasm and MS subgroups, respectively. The most common overall symptoms were motor weakness (48.6 %), cognitive deficits (43.2 %), dysarthria (26.3 %), and ataxia (24.1 %). The former two also constituted the most prevalent manifestations in each subgroup. Lesions were more often localized supratentorially (87.7 %) than infratentorially (27.4 %), especially in the frontal (64.1 %) and parietal lobes (46.6 %), and revealed enhancement in 27.6 % of cases, particularly in the MS (42.9 %) subgroup. Positive JC virus results in the first CSF sample were obtained in 63.5 %, while conversion after one or more negative outcomes occurred in 13.7 % of cases. 52.2 % of patients died, ranging from 12.0 to 83.3 % in the MS and neoplasm subgroups, respectively. In conclusion, despite the heterogeneous nature of the underlying diseases, motor weakness and cognitive changes were the two most common manifestations of drug-associated PML in all subgroups. The frontal and parietal lobes invariably constituted the predilection sites of drug

  5. Solid variant of aneurysmal bone cyst presenting as a giant cervical mass: A clinical, radiological, histopathological dilemma

    PubMed Central

    Savardekar, Amey R.; Patra, Deviprasad; Chatterjee, Debajyoti; Ahuja, Chirag K.; Salunke, Pravin

    2015-01-01

    Background: Typical aneurysmal bone cysts (ABCs) are osteolytic, multicystic lesions with parietal sclerosis and blood-filled cysts. In rare instances, the cystic components may be completely absent. Such solid variants in ABC (s-ABC) exhibit a solid architecture; making the clinical, radiological, and histological differentiation from other solid bone tumors like osteosarcoma (especially giant cell rich osteosarcoma) and giant cell tumor, a difficult task. Case Report: We report the case of a 45–year-old male presenting with a giant solid cervical spine lesion. Histopathology revealed solid variant of ABC, even though the radiological and fine needle aspiration cytology studies pointed toward a giant cell tumor. Conclusion: We aim to discuss the clinical, radiological, and histological findings of solid ABC (a rare benign entity) vis-à-vis the common neoplastic entities of osteosarcoma and giant cell tumor. The histopathological nuisances in making the diagnosis of s-ABC are put forth, along with its impact on management of such giant bony spinal lesions. PMID:26005581

  6. Clinical and radiological signs of ABPA associated with airways infection with Aspergillus in the absence of specific IgE.

    PubMed

    Sunzini, F; Barbato, C; Canofari, C; Lugari, L; Perricone, R; Bergamini, A

    2016-09-01

    Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus that mainly affects patients with asthma. For diagnosis, elevated serum IgE level are needed according to Greenberger and Patterson criteria. We report a case of 43 years-old woman who developed ABPA with productive cough, fever and radiological findings of multiple confluent areas of consolidation in both upper lobes. Laboratory tests showed elevated peripheral eosinophil counts (9.3 x 10(3)/ml). In bronchial washing A. galactomannans and A. Fumigatus were isolated, although we found normal levels of serum IgE, and the absence of serum IgG and IgE antibodies to Aspergillus and A. galactomannans. In conclusion, clinical and radiological signs of ABPA can be associated with Aspergillus infection also in the absence of a specific serum antibody reaction. PMID:27608478

  7. iPad-based patient briefing for radiological examinations-a clinical trial.

    PubMed

    Schlechtweg, Philipp M; Hammon, Matthias; Giese, David; Heberlein, Christian; Uder, Michael; Schwab, Siegfried A

    2014-08-01

    To analyze if an iPad-based patient briefing can serve as a digital alternative to conventional documentations prior to radiological examinations. One hundred one patients referred for routine MRI were randomized into two groups, who underwent iPad-based and classic written briefing in opposite order. For each briefing completion time, completeness and correctness were noted. Patient's knowledge about the content of either briefing modality was subsequently tested. The influence of patient-related factors on the performance of the electronic briefing (EB) was analyzed. Finally, the patient's subjective impression of the EB was assessed. The mean durations were 4.4 ± 2.2 min for EB and 1.7 ± 1.3 min for the classic briefing (p < 0.01). All iPad briefings were returned entirely filled out, whereas 11 % of the classic forms were returned with missing data. No significant differences in memorization of the briefing's information were objectified. There was a positive correlation between the duration of EB and age (r = 0.53; p < 0.01), whereas a negative correlation was found between computer skills and patient's age (r = -0.55; p < 0.01) or duration of EB (r = -0.62; p < 0.01). More than half of the study patients would prefer EB in the future; another 29 % had no preference at all. Patient briefing on iPads transfers the information for the patients equally well compared to the classic written approach. Although iPad briefing took patients longer to perform, the majority would prefer it to written consent briefings in the future. Nevertheless, measures have to be undertaken to improve the overall acceptance and performance.

  8. Measuring Clinical Significance in Rehabilitation Research

    ERIC Educational Resources Information Center

    Johnson, Erica K.; Dow, Christian; Lynch, Ruth T.; Hermann, Bruce P.

    2006-01-01

    Measurement of clinically significant change is critical for rehabilitation research because it can enhance the credibility of rehabilitation efforts and guide evidence-based practices. The practical appeal of clinically significant change is that it can bridge research and clinical practice by focusing on individual rather than group differences.…

  9. Clinical and radiological determinants of prestroke cognitive decline in a stroke cohort

    PubMed Central

    Pohjasvaara, T; Mantyla, R; Aronen, H; Leskela, M; Salonen, O; Kaste, M; Erkinjuntti, T

    1999-01-01

    OBJECTIVES—Stroke seems to be related to dementia more often than previously assumed and vascular factors are also related to Alzheimer's disease. The pathophysiology of poststroke dementia includes ischaemic changes in the brain, a combination of degenerative and vascular changes, and changes only related to Alzheimer's disease. Some cognitive decline recognised after a stroke may be due to pre-existing cognitive decline. The aim of this study was to determine the clinical and radiological determinants of prestroke cognitive decline.
METHODS—The study group comprised 337 of 486 consecutive patients aged 55 to 85 years who 3 months after ischaemic stroke completed a comprehensive neuropsychological test battery; structured medical, neurological, and mental status examination; interview of a knowledgeable informant containing structured questions on abnormality in the cognitive functions; assessment of social functions before the index stroke; and MRI.
RESULTS—Frequency of prestroke cognitive decline including that of dementia was 9.2% (31/337). The patients with prestroke cognitive decline were older, more often had less than 6 years of education, and had history of previous stroke. Vascular risk factors did not differ significantly between these two groups. White matter changes (p=0.004), cortical entorhinal, hippocampal, and medial temporal atrophy (p<0.001), cortical frontal atrophy (p=0.008); and any central atrophy (p<0.01), but not the frequencies or volumes of old, silent, or all infarcts on MRI differentiated those with and without prestroke cognitive decline. The correlates of prestroke cognitive decline in logistic regression analysis were medial temporal cortical atrophy (odds ratio (OR) 7.5, 95% confidence interval (95%CI) 3.2-18.2), history of previous ischaemic stroke (OR 4.4, 95% CI 1.8-10.6), and education (OR 0.9, 95% CI 0.8-0.9).
CONCLUSIONS—History of previous stroke, but not volumes or frequencies was found to correlate with

  10. Effect of topical steroid treatment on idiopathic granulomatous mastitis: clinical and radiologic evaluation.

    PubMed

    Gunduz, Yasemin; Altintoprak, Fatih; Tatli Ayhan, Lacin; Kivilcim, Taner; Celebi, Fehmi

    2014-01-01

    Idiopathic granulomatous mastitis (IGM) is a rare inflammatory, noncaseating, chronic granulomatous benign disease. The etiology of IGM is still unknown. It is postulated to be an autoimmune localized response. The use of a course of oral steroids provides an important regression of breast mass and skin lesions. Topical corticosteroids are used to treat many skin diseases, but no study is available on the sole use of topical steroids for treating IGM. Eleven women with IGM were treated with topical steroid and evaluated using mammography, ultrasonography, and dynamic MRI. At the end of the 12th week, patients were clinically and radiologically evaluated for the regression of breast and skin lesions. Pre- and post-treatment time-intensity curve patterns (TICs) were also compared. During the topical steroid treatment, the inflammation signs in the affected breast had markedly disappeared, the fistulas had become inactive, and the fistula orifices and/or skin erosions had closed in nine patients. The median follow-up period was 17 months (range: 12-48 months). Recurrence was observed in two patients (2/11) at 5 and 8 months, which were treated again topically. The inflammatory findings of the breast skin completely resolved after 8 weeks of treatment, and no side effects or steroid-related complications occurred. In the pretreatment period, TICs from enhancing areas showed a Type 1 pattern in three cases, a Type 2 pattern in five cases, and a Type 3 pattern in three cases. After topical steroid treatment, TIC was not changed only in one patient (Type 2). Type 1 patterns were determined in seven cases and Type 2 patterns in two cases. In addition, in two patients, TICs were not determined due to complete healing. Our MRI findings showed that topical steroid therapy may be useful because it affects mammary parenchyma as well as mammary skin. Further studies with a greater number of patients are needed to determine the topical steroid therapy dosing and duration, and

  11. Fatty acid composition of muscle tissue measured in amphibians living in radiologically contaminated and non-contaminated environments.

    PubMed

    Audette-Stuart, M; Ferreri, C; Festarini, A; Carr, J

    2012-09-01

    Fatty acid composition was identified as a potential biological indicator of the effects of environmental exposure to radiological contaminants. This end point was measured in muscle tissues of Mink frogs ( Rana septentrionalis ) obtained from a radiologically contaminated pond and from a non-contaminated pond. It was also measured after the frogs obtained from both ponds were exposed to a 4 Gy (60)Co γ radiation dose delivered in vivo at a dose rate of approximately 8 Gy/min. Statistically significant differences for the increase of a couple of polyunsaturated omega-3 fatty acid residues and the decrease of a polyunsaturated omega-6 fatty acid residue were observed between radiologically contaminated and non-contaminated frogs, indicating a partial remodeling of muscle lipids in response to a chronic low-dose tritium exposure. The effects of an acute high-dose exposure to (60)Co γ radiation, either for the radiologically contaminated or non-contaminated frogs indicated fast post-irradiation fatty acid changes with an increase of polyunsaturated and decrease of saturated fatty acid contents. Fatty acid composition was found to be a sensitive marker that may be useful to study and monitor biota health in environments that are radiologically contaminated, as well as for understanding the differences between low chronic and high acute stress responses.

  12. Bridging the Gap between Basic and Clinical Sciences: A Description of a Radiological Anatomy Course

    ERIC Educational Resources Information Center

    Torres, Anna; Staskiewicz, Grzegorz J.; Lisiecka, Justyna; Pietrzyk, Lukasz; Czekajlo, Michael; Arancibia, Carlos U.; Maciejewski, Ryszard; Torres, Kamil

    2016-01-01

    A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images…

  13. Radiology/Imaging. Clinical Rotation. Instructor's Packet and Student Study Packet.

    ERIC Educational Resources Information Center

    Texas Univ., Austin. Extension Instruction and Materials Center.

    The instructor's packet, the first of two packets, is one of a series of materials designed to help students who are investigating the activities within a radiology department or considering any of the imaging technologies as a career. The material is designed to relate training experience to information studied in the classroom. This packet…

  14. The relationship of anthropometric measures to radiological features of the breast in premenopausal women.

    PubMed Central

    Boyd, N. F.; Lockwood, G. A.; Byng, J. W.; Little, L. E.; Yaffe, M. J.; Tritchler, D. L.

    1998-01-01

    We studied 273 premenopausal women recruited from mammography units who had different degrees of density of the breast parenchyma on mammography, in whom we measured height, weight and skinfold thicknesses. Mammograms were digitized to high spatial resolution by a scanning densitometer and images analysed to measure the area of dense tissue and the total area of the breast. Per cent density and the area of non-dense tissue were calculated from these measurements. We found that the mammographic measures had different associations with body size. Weight and the Quetelet index of obesity were strongly and positively associated with the area of non-dense tissue and with the total area of the breast, but less strongly and negatively correlated with the area of dense tissue. We also found a strong inverse relationship between the areas of radiologically dense and non-dense breast tissue. Statistical models containing anthropometric variables explained up to 8% of the variance in dense area, but explained up to 49% of the variance in non-dense area and 43% of variance in total area. These results suggest that aetiological studies in breast cancer that use mammographic density should consider dense and non-dense tissues separately. In addition to per cent density, methods should be examined that combine information from these two tissues. Images Figure 1 PMID:9820186

  15. Combining Radiography and Passive Measurements for Radiological Threat Localization in Cargo

    SciTech Connect

    Miller, Erin A.; White, Timothy A.; Jarman, Kenneth D.; Kouzes, Richard T.; Kulisek, Jonathan A.; Robinson, Sean M.; Wittman, Richard A.

    2015-10-01

    Detecting shielded special nuclear material (SNM) in a cargo container is a difficult problem, since shielding reduces the amount of radiation escaping the container. Radiography provides information that is complementary to that provided by passive gamma-ray detection systems: while not directly sensitive to radiological materials, radiography can reveal highly shielded regions that may mask a passive radiological signal. Combining these measurements has the potential to improve SNM detection, either through improved sensitivity or by providing a solution to the inverse problem to estimate source properties (strength and location). We present a data-fusion method that uses a radiograph to provide an estimate of the radiation-transport environment for gamma rays from potential sources. This approach makes quantitative use of radiographic images without relying on image interpretation, and results in a probabilistic description of likely source locations and strengths. We present results for this method for a modeled test case of a cargo container passing through a plastic-scintillator-based radiation portal monitor and a transmission-radiography system. We find that a radiograph-based inversion scheme allows for localization of a low-noise source placed randomly within the test container to within 40 cm, compared to 70 cm for triangulation alone, while strength estimation accuracy is improved by a factor of six. Improvements are seen in regions of both high and low shielding, but are most pronounced in highly shielded regions. The approach proposed here combines transmission and emission data in a manner that has not been explored in the cargo-screening literature, advancing the ability to accurately describe a hidden source based on currently-available instrumentation.

  16. Clinical, pathological, and radiological characteristics of solitary ground-glass opacity lung nodules on high-resolution computed tomography

    PubMed Central

    Qiu, Zhi-Xin; Cheng, Yue; Liu, Dan; Wang, Wei-Ya; Wu, Xia; Wu, Wei-Lu; Li, Wei-Min

    2016-01-01

    Background Lung nodules are being detected at an increasing rate year by year with high-resolution computed tomography (HRCT) being widely used. Ground-glass opacity nodule is one of the special types of pulmonary nodules that is confirmed to be closely associated with early stage of lung cancer. Very little is known about solitary ground-glass opacity nodules (SGGNs). In this study, we analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT. Methods A total of 95 resected SGGNs were evaluated with HRCT scan. The clinical, pathological, and radiological characteristics of these cases were analyzed. Results Eighty-one adenocarcinoma and 14 benign nodules were observed. The nodules included 12 (15%) adenocarcinoma in situ (AIS), 14 (17%) minimally invasive adenocarcinoma (MIA), and 55 (68%) invasive adenocarcinoma (IA). No patients with recurrence till date have been identified. The positive expression rates of anaplastic lymphoma kinase and ROS-1 (proto-oncogene tyrosine-protein kinase ROS) were only 2.5% and 8.6%, respectively. The specificity and accuracy of HRCT of invasive lung adenocarcinoma were 85.2% and 87.4%. The standard uptake values of only two patients determined by 18F-FDG positron emission tomography/computed tomography (PET/CT) were above 2.5. The size, density, shape, and pleural tag of nodules were significant factors that differentiated IA from AIS and MIA. Moreover, the size, shape, margin, pleural tag, vascular cluster, bubble-like sign, and air bronchogram of nodules were significant determinants for mixed ground-glass opacity nodules (all P<0.05). Conclusion We analyzed the clinical, pathological, and radiological characteristics of SGGNs on HRCT and found that the size, density, shape, and pleural tag of SGGNs on HRCT are found to be the determinant factors of IA. In conclusion, detection of anaplastic lymphoma kinase expression and performance of PET/CT scan are not routinely recommended. PMID:27703366

  17. Comparative Study of Clinical and Radiological Outcomes of Unconstrained Bicondylar Total Knee Endoprostheses with Anti-allergic Coating

    PubMed Central

    Bergschmidt, Philipp; Bader, Rainer; Finze, Susanne; Schulze, Christoph; Kundt, Guenther; Mittelmeier, Wolfram

    2011-01-01

    Background: Hypersensitivity reactions to implant materials have become more important in total knee replacement (TKR). The purpose of this retrospective comparative study was to evaluate the clinical and radiological outcomes of unconstrained bicondylar total knee prostheses with and without anti-allergic titanium(niobium)nitrite (Ti(Nb)N) coating. Methods: Twenty-four patients (25 TKRs) underwent a preoperative clinical evaluation and then a postoperative evaluation after 26.2 months in the allergy group treated with coated implants (n=13 implants) and after 24.5 months in the control group treated with uncoated implants but identical geometry (n=12) using HSS, WOMAC and SF-36 scores. Radiological evaluations were performed using standard anterior-posterior (a.p.) and lateral X-rays. Results: During follow-up two patients of the allergy group had to undergo revision surgery due to non-implant-related reasons. A comparative analysis of both study groups showed a significant difference in the HSS scores at both evaluation time points (MW test p≤0.050); these findings are remarkable since the control group had a significantly lower score preoperatively (54.0 vs 65.0 points) and a significantly higher score (82.5 vs 75.0 points) postoperatively. The preoperative and postoperative WOMAC and SF-36 scores were comparable in both groups (MW test p≥0.052), although the postoperative increase in the score for the allergy group was lower. The radiological results were comparable in both groups and were unlikely to influence the results. Conclusions: This clinical study demonstrates the restricted outcome in postoperative function and quality of life in the allergy group compared to the control group. PMID:22016754

  18. Radiological and Clinical Factors Predicting the Facial Nerve Outcome following Retrosigmoid Approach for Large Vestibular Schwannomas (VSs).

    PubMed

    Sharma, Mayur; Sonig, Ashish; Ambekar, Sudheer; Nanda, Anil

    2013-10-01

    Objective The aim of our study was to identify the radiological and clinical factors that predict postoperative facial nerve outcome following retrosigmoid approach for large vestibular schwannomas (VSs). Methods A total of 72 patients with large (≥ 3 cm) vestibular schwannomas was included in this retrospective study. Various parameters evaluated were age, gender, clinical presentation, tumor diameter in three planes, intrameatal extension, and pattern of growth. Results Age of the patient and presenting symptoms such as headache, ataxia, or preoperative facial nerve dysfunction correlated with poorer facial nerve outcome (p < 0.05). Patients with larger tumor volumes and extrameatal growth experienced a worse outcome (p < 0.05). Anterior and caudal extension (p = 0.001) correlated with poorer outcome, as well. Intrameatal extension and bony changes of the internal acoustic meatus did not correlate with the outcome (p > 0.05). Of the various examined factors, preoperative facial nerve function independently predicted postoperative facial nerve outcome. Conclusion Our study suggests that young patients with small tumor volume and normal facial nerve function at presentation are more likely to experience a good postoperative facial nerve outcome. These clinical and radiological parameters can be used to predict facial nerve outcome prior to surgery.

  19. Pathogenesis, clinical course and neuro-radiological signs of Proprionibacterium acnes cerebritis: Case report and literature review.

    PubMed

    Yakhkind, Aleksandra; Yacoub, Hussam A; Grove, Jacqueline; Varrato, Jay D; Castaldo, John E

    2015-01-01

    The clinical and neuroimaging characteristics of brain infections related to Propionibacterium acnes are not well-characterized, making early diagnosis and treatment a challenge. More recently, life-threatening central nervous system infections with P. acnes are being reported with increasing frequency as complications of neurointerventional procedures. We present a rare case of P. acnes cerebritis that occurred as a sequela of bare platinum aneurysm coiling and a contaminant of percutaneous angiographic intervention. We include an extensive review of the literature describing the pathogenesis of P. acnes and neuro-radiological signs of brain infections related to this pathogen. PMID:25762004

  20. Dynamic Cervical Implant versus Anterior Cervical Diskectomy and Fusion: A Prospective Study of Clinical and Radiologic Outcome.

    PubMed

    Richter, Heiko; Seule, Martin; Hildebrandt, Gerhard; Fournier, Jean-Yves

    2016-07-01

    Objective To evaluate clinical and radiologic outcome in patients treated with a dynamic cervical implant (DCI) or anterior cervical diskectomy and fusion (ACDF). Study Design A prospective comparative cohort study. Methods The study included 60 patients with one- or two-level cervical degenerative disk disease (DDD) undergoing treatment with either DCI (n = 30) or ACDF (n = 30). Clinical and radiologic outcomes were assessed 3 and 12 months after surgery. Clinical scoring systems included the Visual Analog Scale for Neck (VAS-N) and Arm pain (VAS-A), the Neck Pain and Disability Scale (NPAD), and the European Quality of Life Scale (EQ-5D). Results Both the DCI and ACDF group showed significant clinical improvement 12 months after surgery using the VAS-N (p = 0.034 and p < 0.001, respectively), VAS-A (p < 0.001 and p < 0.001, respectively), NPAD (p < 0.001 and p < 0.001, respectively), and EQ-5D (p < 0.001 and p < 0.001, respectively). There were no significant differences in clinical outcome comparing both groups at the 3- and 12-month follow-up. The fusion rate at 12 months after surgery was 39.4% and 80.0% in the DCI and ACDF groups, respectively. Radiolucency was found in 90.9% in the DCI group at 12-month follow-up. Conclusion The clinical results for DCI treatment are equivalent to those for ACDF in the treatment of one- and two-level cervical DDD at 12 months after surgery. Further studies are necessary to investigate the high rates of radiolucency and fusion associated with DCI treatment. PMID:27088592

  1. Dynamic Cervical Implant versus Anterior Cervical Diskectomy and Fusion: A Prospective Study of Clinical and Radiologic Outcome.

    PubMed

    Richter, Heiko; Seule, Martin; Hildebrandt, Gerhard; Fournier, Jean-Yves

    2016-07-01

    Objective To evaluate clinical and radiologic outcome in patients treated with a dynamic cervical implant (DCI) or anterior cervical diskectomy and fusion (ACDF). Study Design A prospective comparative cohort study. Methods The study included 60 patients with one- or two-level cervical degenerative disk disease (DDD) undergoing treatment with either DCI (n = 30) or ACDF (n = 30). Clinical and radiologic outcomes were assessed 3 and 12 months after surgery. Clinical scoring systems included the Visual Analog Scale for Neck (VAS-N) and Arm pain (VAS-A), the Neck Pain and Disability Scale (NPAD), and the European Quality of Life Scale (EQ-5D). Results Both the DCI and ACDF group showed significant clinical improvement 12 months after surgery using the VAS-N (p = 0.034 and p < 0.001, respectively), VAS-A (p < 0.001 and p < 0.001, respectively), NPAD (p < 0.001 and p < 0.001, respectively), and EQ-5D (p < 0.001 and p < 0.001, respectively). There were no significant differences in clinical outcome comparing both groups at the 3- and 12-month follow-up. The fusion rate at 12 months after surgery was 39.4% and 80.0% in the DCI and ACDF groups, respectively. Radiolucency was found in 90.9% in the DCI group at 12-month follow-up. Conclusion The clinical results for DCI treatment are equivalent to those for ACDF in the treatment of one- and two-level cervical DDD at 12 months after surgery. Further studies are necessary to investigate the high rates of radiolucency and fusion associated with DCI treatment.

  2. [Measurement of the Dose Rate Using Dosimeters in Interventional Radiology and Its Difficulty].

    PubMed

    Yoshida, Hidenori; Takahashi, Chiharu; Narita, Nobuhiro; Mizusawa, Yasuhiko; Sekiya, Masaru; Ohkubo, Masaki

    2016-01-01

    In equipment used for interventional radiology (IVR), automatic exposure control (AEC) is incorporated to obtain the X-ray output suitable for the treatment of targeted lesions. For the AEC, users select a region as the signal sensing region (measuring field, MF) in the flat panel detector; MFs with various sizes and shapes were pre-defined and prepared in the system. The aim of this study was to examine the change of measured dose rate with the selection of MFs, the type of dosimeters (the ionization chamber dosimeter and the semiconductor dosimeter), and the dosimeter placement relative to the direction of X-ray tube (from cathode to anode). The IVR equipment was Allura Xper FD20/10 (Philips Medical Systems), and six kinds of built-in MFs were used. It was found that dose rate measured by the ionization chamber dosimeter showed a variation of -2 mGy/min with the MFs and the ionization chamber dosimeter placement. The dose rate measured by the semiconductor dosimeter showed more variation than the ionization chamber dosimeter. The change of dose rate with the dosimeter placement would be caused by the MF overlapping the dosimeter which would affect the AEC (the X-ray output). Also, the change of dose rate with the dosimeter placement was considered to be related to the heel effect of the X-ray beam. When performing dose rate measurements, we should notice that the selection of MFs, the type of dosimeters, and the dosimeter placement would affect the measured values. PMID:26796935

  3. Clinical evaluation of using semantic searching engine for radiological imaging services in RIS-integrated PACS

    NASA Astrophysics Data System (ADS)

    Ling, Tonghui; Zhang, Kai; Yang, Yuanyuan; Hua, Yanqing; Zhang, Jianguo

    2015-03-01

    We had designed a semantic searching engine (SSE) for radiological imaging to search both reports and images in RIS-integrated PACS environment. In this presentation, we present evaluation results of this SSE about how it impacting the radiologists' behaviors in reporting for different kinds of examinations, and how it improving the performance of retrieval and usage of historical images in RIS-integrated PACS.

  4. Quality initiatives: anatomy and pathophysiology of errors occurring in clinical radiology practice.

    PubMed

    Brook, Olga R; O'Connell, Anna Marie; Thornton, Eavan; Eisenberg, Ronald L; Mendiratta-Lala, Mishal; Kruskal, Jonathan B

    2010-09-01

    The Joint Commission requires development of comprehensive error detection systems that incorporate root cause analyses for all sentinel events. To prevent medical errors from occurring, there is a need for a readily available and easy-to-implement system for detecting, classifying, and managing mistakes. The wide spectrum of interrelated contributing factors makes the classification of errors difficult. Contributors to and causes of radiologic errors can be classified under latent and active failures. Latent failures include technical and system-related failures, with a radiology-specific subgroup of communication failures that includes documentation, inaccurate or incomplete information, and communication loop failures. Active failures may be ascribed to human failures (more specifically failure of execution of a task, inadequate planning, or behavior-related failures), patient-based failures, and external failures. Classification of an error should also include the impact of the error on the patient, staff, other customers, and radiology practice. Further considerations should include nonmedical impact of the error, including legal, social, and economic effects on both the patient and the system. Rather than focusing the investigation on blaming individuals for active failures, the primary effort should be to discover latent system failures that can be remedied at a departmental level. Such an error classification system will decrease the likelihood of future errors and diminish their adverse impact. PMID:20622192

  5. Clinical and radiological results after implantation of the femoral neck preserving Delfi M hip prosthesis: a case series.

    PubMed

    Budde, Stefan; Windhagen, Henning; Lerch, Matthias; Broese, Maximilian; Götze, Patricc; Thorey, Fritz

    2012-01-01

    Various types of bone preserving total hip prostheses with a proximal force transmission concept have been developed for younger adults, one of these being the implant "Delfi M®", produced by ESKA until 2009. Since the demand could not meet the expectations, the production was stopped due to economic reasons so that only 31 implants of this type were sold and even less actually implanted. This study followed up 15 Delfi M® prostheses in 12 patients for 3.1 years and represents the only existing valid data about this implant.Demographical, preoperative and postoperative data including clinical scores (HOOS and mHHS) were collected retrospectively. Postoperative X-rays were analyzed by an independent radiologist. One implant had to be exchanged due to an infection and another one due to excessive implant migration. The mHHS and the HOOS scores showed a significant improvement after surgery. In the radiological analysis, there were no signs of radiolucent lines or osteolyses.This trial demonstrates good clinical and radiological midterm results for the Delfi M prosthesis. Limitations of this study are a small sample size and a follow-up time of 3 years at only one timepoint.

  6. Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification.

    PubMed

    Santosh, P

    2015-01-01

    Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar. PMID:26229709

  7. Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification

    PubMed Central

    Santosh, P

    2015-01-01

    Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar. PMID:26229709

  8. Transcrestal Sinus Lift Procedure Approaching Atrophic Maxillary Ridge: A 60-Month Clinical and Radiological Follow-Up Evaluation

    PubMed Central

    Lo Giudice, G.; Iannello, G.; Terranova, A.; Lo Giudice, R.; Pantaleo, G.; Cicciù, M.

    2015-01-01

    Aim. The aim of this study was to assess the success and the survival rate of dental implants placed in augmented bone after sinus lifting procedures. Material and Methods. 31 patients were mainly enrolled for a residual upper jaw crest thickness of 3 mm. CBCT scans were performed before and after the augmentation technique and at the follow-up appointments, at 3, 6, 12, 24, and up to 60 months. The follow-up examination included cumulative survival rate of implants, peri-implant marginal bone loss, and the height of sinus floor augmentation. Results. This retrospective study on 31 patients and 45 implants later inserted in a less than 3 mm crest showed excellent survival rates (99.5%), one implant was lost before loading due to an acute infection after 24 days, and two implants did not osteointegrate and were removed after 3 months. The radiological evaluation showed an average bone loss of 0.25 mm (±0.78 mm) at the first follow-up appointment (3 months) up to 0.30 mm (±1.28 mm) after 60-month follow-up. Conclusion. In this study it was reported how even in less than 3 mm thick crest a transcrestal technique can predictably be used with a long-term clinical and radiological outcome, giving patients excellent stability of the grafted material and healthy clinical results. PMID:26451145

  9. Radiological and Clinical Pneumonitis After Stereotactic Lung Radiotherapy: A Matched Analysis of Three-Dimensional Conformal and Volumetric-modulated Arc Therapy Techniques

    SciTech Connect

    Palma, David A.; Senan, Suresh; Haasbeek, Cornelis J.A.; Verbakel, Wilko F.A.R.; Vincent, Andrew; Lagerwaard, Frank

    2011-06-01

    Purpose: Lung fibrosis is common after stereotactic body radiotherapy (SBRT) for lung tumors, but the influence of treatment technique on rates of clinical and radiological pneumonitis is not well described. After implementing volumetric modulated arc therapy (RapidArc [RA]; Varian Medical Systems, Palo Alto, CA) for SBRT, we scored the early pulmonary changes seen with arc and conventional three-dimensional SBRT (3D-CRT). Methods and Materials: Twenty-five SBRT patients treated with RA were matched 1:2 with 50 SBRT patients treated with 3D-CRT. Dose fractionations were based on a risk-adapted strategy. Clinical pneumonitis was scored using Common Terminology Criteria for Adverse Events version 3.0. Acute radiological changes 3 months posttreatment were scored by three blinded observers. Relationships among treatment type, baseline factors, and outcomes were assessed using Spearman's correlation, Cochran-Mantel-Haenszel tests, and logistic regression. Results: The RA and 3D-CRT groups were well matched. Forty-three patients (57%) had radiological pneumonitis 3 months after treatment. Twenty-eight patients (37%) had computed tomography (CT) findings of patchy or diffuse consolidation, and 15 patients (20%) had ground-glass opacities only. Clinical pneumonitis was uncommon, and no differences were seen between 3D-CRT vs. RA patients in rates of grade 2/3 clinical pneumonitis (6% vs. 4%, respectively; p = 0.99), moderate/severe radiological changes (24% vs. 36%, respectively, p = 0.28), or patterns of CT changes (p = 0.47). Radiological severity scores were associated with larger planning target volumes (p = 0.09) and extended fractionation (p = 0.03). Conclusions: Radiological changes after lung SBRT are common with both approaches, but no differences in early clinical or radiological findings were observed after RA. Longer follow-up will be required to exclude late changes.

  10. Clinical and radiological results after coracoclavicular ligament reconstruction for type III acromioclavicular joint dislocation using three different techniques. A retrospective study

    PubMed Central

    VASCELLARI, ALBERTO; SCHIAVETTI, STEFANO; BATTISTELLA, GIUSEPPE; REBUZZI, ENRICO; COLETTI, NICOLÒ

    2015-01-01

    Purpose the purpose of this retrospective study was to present the outcomes of three different techniques for the treatment of type III acromioclavicular joint dislocations: arthroscopic TightRope (TR), arthroscopic GraftRope (GR), and open reconstruction of the coracoclavicular (CC) ligament using the Ligament Augmentation and Reconstruction System (LARS). Methods eighteen patients underwent clinical and radiological evaluations after a mean follow-up time of 43 months. The following clinical outcome measures were considered: the Disability of the Arm, Shoulder and Hand outcome measure (DASH), the Nottingham Clavicle Score (NCS), and the Constant score (CS). On X-rays, the CC distance was measured. Results the median DASH score at follow-up was 12.5 in the TR group, 5 in the GR group, and 4.2 in the LARS group. The median NCS value was 88 in the TR group, 88 in the GR group, and 91 in the LARS group. The median CS was 100 in the TR group, 95 in the GR group, and 94.5 in the LARS group. The mean CC distance was 10.3 mm in the TR group, 13.8 in the GR group, and 16.6 in the LARS group. Conclusions all three techniques proved to be reliable in providing good clinical outcomes, although none of the studied techniques demonstrated reliability in maintaining anatomical reduction after surgery. Level of evidence Level III, retrospective comparative study. PMID:26605251

  11. Retrospective Comparison of Radiological and Clinical Outcomes of PLIF and TLIF Techniques in Patients Who Underwent Lumbar Spinal Posterior Stabilization

    PubMed Central

    Asil, Kiyasettin; Yaldiz, Can

    2016-01-01

    Abstract Degenerative disc disease and spinal stenosis lead to various symptoms. Degeneration of facet joints is added to this degenerative process with aging. Seventy-four patients who were admitted to the Spinal Column Outpatient Clinic of the Neurosurgery Department with a diagnosis of degenerative narrow spinal canal and lumbar spondylolisthesis between 2011 and 2013 and who underwent surgery were included in the study. Our study was conducted with 74 patients of whom 73.0% (n = 54) were female and 27.0% (n = 20) were male. Mean age was 54.86 ± 7.87 years (range 34–74). Although we did not detect a difference between the two surgical methods with regard to clinical improvement, transforaminal lumbar interbody fusion (TLIF) is preferred due to radiological advantages observed one year later, ease of application, and the development of fewer complications. PMID:27124016

  12. Clinical and Radiological Characteristics of Lumbosacral Lateral Disc Herniation in Comparison With Those of Medial Disc Herniation

    PubMed Central

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-01-01

    Abstract Lateral disc herniation (foraminal and extra foraminal) has clinical characteristics that are different from those of medial disc herniation (central and subarticular), including older age, more frequent radicular pain, and neurologic deficits. This is supposedly because lateral disc herniation mechanically irritates or compresses the exiting nerve root or dorsal root ganglion inside of a narrow canal more directly than medial disc herniation. The purpose of this study was to investigate clinical and radiological characteristics of lateral disc herniation in comparison with medial disc herniation. The 352 subjects diagnosed with localized lumbosacral disc herniation and followed up for at least 12 months after completion of treatment were included and divided into medial and lateral disc herniation groups, according to the anatomical location of the herniated disc in axial plain of magnetic resonance image. Clinical and radiological data were obtained and compared between the two groups. The lateral group included 74 (21%) patients and the medial group included 278 (79%). Mean age of the lateral group was significantly higher than that in the medial group. The lateral group showed a significantly larger proportion of patients with radiating leg pain and multiple levels of disc herniations than the medial group. No significant differences were found in terms of gender, duration of pain, pretreatment numeric rating scale, severity of disc herniation (protrusion and extrusion), and presence of weakness in leg muscles. The proportion of patients who underwent surgery was not significantly different between the 2 groups. However, the proportion of patients who accomplished successful pain reduction after treatment was significantly smaller in the lateral than in the medial group. In conclusion, patients with lateral disc herniation were older and had larger proportion of radiating leg pain than those with medial disc herniation. Lateral disc herniation was more

  13. Clinical and Radiological Characteristics of Lumbosacral Lateral Disc Herniation in Comparison With Those of Medial Disc Herniation.

    PubMed

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-02-01

    Lateral disc herniation (foraminal and extra foraminal) has clinical characteristics that are different from those of medial disc herniation (central and subarticular), including older age, more frequent radicular pain, and neurologic deficits. This is supposedly because lateral disc herniation mechanically irritates or compresses the exiting nerve root or dorsal root ganglion inside of a narrow canal more directly than medial disc herniation. The purpose of this study was to investigate clinical and radiological characteristics of lateral disc herniation in comparison with medial disc herniation. The 352 subjects diagnosed with localized lumbosacral disc herniation and followed up for at least 12 months after completion of treatment were included and divided into medial and lateral disc herniation groups, according to the anatomical location of the herniated disc in axial plain of magnetic resonance image. Clinical and radiological data were obtained and compared between the two groups. The lateral group included 74 (21%) patients and the medial group included 278 (79%). Mean age of the lateral group was significantly higher than that in the medial group. The lateral group showed a significantly larger proportion of patients with radiating leg pain and multiple levels of disc herniations than the medial group. No significant differences were found in terms of gender, duration of pain, pretreatment numeric rating scale, severity of disc herniation (protrusion and extrusion), and presence of weakness in leg muscles. The proportion of patients who underwent surgery was not significantly different between the 2 groups. However, the proportion of patients who accomplished successful pain reduction after treatment was significantly smaller in the lateral than in the medial group. In conclusion, patients with lateral disc herniation were older and had larger proportion of radiating leg pain than those with medial disc herniation. Lateral disc herniation was more

  14. Liposarcoma or invasive lipomatosis in flower horn fish, hybrid cichlid: clinical, radiological, ultrasonographical and histopathological study.

    PubMed

    Rahmati-Holasoo, H; Shokrpoor, S; Tavakkoli, A; Vajhi, A; Ebrahimzadeh Mousavi, H

    2016-03-01

    Liposarcoma or invasive lipomatosis affecting three indoor aquarium fish (flower horn fish, hybrid cichlid) is characterized, by the presence of mature adipocytes of variable sizes and by an invasive behaviour, which affected internal organs and eyes of all cases. Detailed macroscopic, radiological, ultrasonographical and histopathological features are presented. All fish had bilateral exophthalmia with some masses around the eyes. Ultrasonography confirmed the presence of hyperechoic masses in the eyes. Histopathology of all cases described the presence of variable-sized adipose cells in the eyes. The suggested diagnosis is well-differentiated liposarcoma or invasive lipomatosis. This is the first report of liposarcoma or invasive lipomatosis in flower horn fish, hybrid cichlid.

  15. Objective measures of quality assurance in a computed radiography-based radiology department

    NASA Astrophysics Data System (ADS)

    Willis, Charles E.; Leckie, Robert G.; Carter, Jon R.; Williamson, Morgan P.; Scotti, Stephen D.; Norton, Gary S.

    1995-05-01

    Parameters are needed to assess quality assurance in a radiology department where computed radiography (CR) is the principal means of image acquisition. Laser-printed computed radiographs were collected for all patients examined over a period of several days. A sample of 1200 was sorted by subject anatomy and the associated exam information was entered into an EXCEL spreadsheet. Sensitivity (S) numbers were sorted into histogram and analyzed using standard descriptive statistics. Each film was over-read by a board-certified radiologist to assess whether the image was diagnostic and to determine if there were pathologic findings. A significant proportion of images were acquired using inappropriate menu codes. The histogram of S numbers for a given menu code describes a log normal distribution. The S number depends on the technologist's ability to control the technique. A significant proportion of the images were deemed non diagnostic, and many correlated to excessive S numbers. Some were a result of mispositioning. The S number is a valid retrospective measure of radiographic quality assurance. Departments using CR should strive for control on menu codes selected and S numbers produced. Such data should be available from PACS databases.

  16. Highly Aggressive HPV-related Oropharyngeal Cancer: Clinical, Radiologic, and Pathologic Characteristics

    PubMed Central

    Kaka, Azeem S.; Kumar, Bhavna; Kumar, Pawan; Wakely, Paul E.; Kirsch, Claudia M.; Old, Matthew O.; Ozer, Enver; Agrawal, Amit; Carrau, Ricardo E.; Schuller, David E.; Siddiqui, Farzan; Teknos, Theodoros N.

    2013-01-01

    Objectives While the majority of HPV+ oropharyngeal squamous cell carcinomas have a favorable prognosis, we search for markers of poor prognosis by carefully examining a subset of highly-aggressive cases. Study Design Seven patients with HPV+ oropharyngeal cancer who presented with non-pulmonary distant metastasis or developed distant metastasis post-treatment were identified. Eight control cases were chosen which responded well to treatment. Pathology and radiological studies were reviewed and compared. Results Two cases displayed a small cell carcinoma (SmCC) component upon pathologic review. Biomarker analysis revealed lower expression of NOTCH1 in the aggressive cohort in comparison to controls (p=0.04). Cases showed a predominance of clustering of lymph nodes, extracapsular spread and central tumor necrosis. Conclusion While most HPV-related oropharyngeal cancers display a positive prognosis, it is evident that there is a subset, which behave more aggressively. This early investigation identifies pathologic and radiologic features that may help to predict this behavior. PMID:23770280

  17. [Server World-Wide Web on the Internet for the provision of clinical cases and digital radiologic images for training and continuing education in radiology].

    PubMed

    Sparacia, G; Tartamella, M; Finazzo, M; Bartolotta, T; Brancatelli, G; Banco, A; Lo Casto, A; La Tona, G; Bentivegna, E

    1997-06-01

    The Internet, as a global computer network, provides opportunities to make available multimedia educational materials, such as teaching files and image databases, that can be accessed using "World-Wide Web" client browser to provide continuing medical education. Since August, 1995, at the Institute of Radiology-University of Palermo, we developed a World-Wide Web server on the Internet to provide a collection of interactive radiology educational resources such as teaching files and image database for continuing medical education in radiology. Our server is based on a UNIX workstation connected to the Internet via our campus Ethernet network and reachable at the uniform resource locator (URL) address: http:/(/)mbox.unipa.it/approximately radpa/ radpa.html. Digital CT and MR images for teaching files and image database are downloaded through an Ethernet local area network from a GE Advantage Windows workstation. US images will be acquired on-line through a video digitizing board. Radiographs will be digitized by means of a Charge Coupled Device (CCD) scanner. To set up teaching files, image database and all other documents, we use the standard "HyperText Markup Language" (HTML) to edit the documents, and the Graphics Interchange Format (GIF) or Joint Photographic Expert Group (JPEG) format to store the images. Nine teaching files are presently available on the server, together with 49 images in the database, a list of international radiological servers, a section devoted to the museum of radiology hosted by our Institute, the electronic version of the Journal Eido Electa. In the first 12 months of public access through the Internet, 12,280 users accessed the server worldwide: 45% of them to retrieve teaching files; 35% to retrieve images from the database; the remaining 20% to retrieve other documents. Placing teaching files and image database on a World-Wide Web server makes these cases more available to residents and radiologists to provide continuing medical

  18. Role of clinical, radiological, and neurophysiological changes in predicting the outcome of tuberculous meningitis: a multivariable analysis

    PubMed Central

    Misra, U; Kalita, J; Roy, A; Mandal, S; Srivastava, M

    2000-01-01

    OBJECTIVES—The role of EEG and evoked potentials has not been evaluated in predicting the prognosis of tuberculous (TB) meningitis. The present study was aimed at evaluating the prognostic significance of clinical, radiological, and neurophysiological variables using multi-variable analysis.
METHODS—Patients with TB meningitis diagnosed on the basis of clinical, radiological, and CSF criteria have been prospectively evaluated. All the patients were subjected to a detailed neurological evaluation. The outcome was defined 6 months after starting treatment on the basis of the Barthel index (BI) score into poor (BI <12) and good recovery (BI⩾12). Death was included in the poor recovery group for statistical analysis. Thirteen clinical (age, sex, seizure, focal weakness, stage of meningitis, Glasgow coma scale score, methyl prednisolone therapy), CT (infarction, hydrocephalus, tuberculoma) and neurophysiological (EEG, motor and somatosensory evoked potentials) variables were evaluated employing single variable logistic regression followed by multivariable logistic regression analysis. The best set of predictors were obtained by stepdown logistic regression analysis.
RESULTS—Fifty four patients were included in the present study. Their age ranged between 5 and 62 years, 11 were children younger than 12 years and 14 were female. Nine patients were in stage I meningitis, 12 in stage II, and 33 in stage III. On single variable logistic regression analysis the significant predictors of 6 months outcome of TB meningitis included focal weakness, Glasgow coma scale (GCS), motor evoked potential (MEP) and somatosensory evoked potential (SEP). On multivariable analysis the best set of predictors comprised focal weakness, GCS, and SEP.
CONCLUSIONS—In patients with TB meningitis focal weakness, GCS, and SEP are the best predictors of 6 month outcome.

 PMID:10675210

  19. Surgical Treatment of Unstable Distal Radius Fractures With a Volar Variable-Angle Locking Plate: Clinical and Radiological Outcomes

    PubMed Central

    Khatri, Kavin; Sharma, Vijay; Farooque, Kamran; Tiwari, Vivek

    2016-01-01

    Background Unstable distal end radius fractures are difficult to manage and so various treatment modalities have been described. The use of variable-angle locking plates is promoted for the management of these fractures. Objectives This study aimed to evaluate the functional and radiological outcomes in unstable distal end radius fractures treated with variable-angle locking plates. Patients and Methods We reviewed 23 unstable distal end radius fractures that were treated at our institution with volar variable-angle locking plates. The mean age of the patients was 32.82 ± 11.81 years (range 19 to 62) and the mean duration of follow-up was 11.04 ± 2.47 months (range 6 to 15). All of the patients underwent open reduction and internal fixation with a variable-angle locking plate. Radiological parameters such as radial inclination, length, tilt, and ulnar variance were measured at six weeks and at the final follow-up. The functional evaluation was conducted by measuring the range of motion at the wrist joint as well as the grip strength. Gartland and Werley’s demerit scoring system was used to assess the final outcome. Results There were two cases of superficial infection that responded to oral antibiotics. One patient had developed a hypertrophic scar, while another had carpal tunnel syndrome that was conservatively managed. There was a significant improvement in the functional indices from six weeks to the final follow-up, while the radiological parameters were maintained. According to Gartland and Werley, excellent results were reported in 65.2% cases, while good results were present in 35% cases. Conclusions The use of variable-angle locking plates in treating unstable distal end radius fractures is associated with excellent to good functional outcomes with minimal complications.

  20. Surgical Treatment of Unstable Distal Radius Fractures With a Volar Variable-Angle Locking Plate: Clinical and Radiological Outcomes

    PubMed Central

    Khatri, Kavin; Sharma, Vijay; Farooque, Kamran; Tiwari, Vivek

    2016-01-01

    Background Unstable distal end radius fractures are difficult to manage and so various treatment modalities have been described. The use of variable-angle locking plates is promoted for the management of these fractures. Objectives This study aimed to evaluate the functional and radiological outcomes in unstable distal end radius fractures treated with variable-angle locking plates. Patients and Methods We reviewed 23 unstable distal end radius fractures that were treated at our institution with volar variable-angle locking plates. The mean age of the patients was 32.82 ± 11.81 years (range 19 to 62) and the mean duration of follow-up was 11.04 ± 2.47 months (range 6 to 15). All of the patients underwent open reduction and internal fixation with a variable-angle locking plate. Radiological parameters such as radial inclination, length, tilt, and ulnar variance were measured at six weeks and at the final follow-up. The functional evaluation was conducted by measuring the range of motion at the wrist joint as well as the grip strength. Gartland and Werley’s demerit scoring system was used to assess the final outcome. Results There were two cases of superficial infection that responded to oral antibiotics. One patient had developed a hypertrophic scar, while another had carpal tunnel syndrome that was conservatively managed. There was a significant improvement in the functional indices from six weeks to the final follow-up, while the radiological parameters were maintained. According to Gartland and Werley, excellent results were reported in 65.2% cases, while good results were present in 35% cases. Conclusions The use of variable-angle locking plates in treating unstable distal end radius fractures is associated with excellent to good functional outcomes with minimal complications. PMID:27679785

  1. Clinical Outcome Measures in Chiari I Malformation.

    PubMed

    Yarbrough, Chester K; Greenberg, Jacob K; Park, Tae Sung

    2015-10-01

    Chiari malformation type 1 (CM-I) is a common and often debilitating neurologic disease. Reliable evaluation of treatments has been hampered by inconsistent use of clinical outcome measures. A variety of outcome measurement tools are available, although few have been validated in CM-I. The recent development of the Chicago Chiari Outcome Scale and the Chiari Symptom Profile provides CM-I-specific instruments to measure outcomes in adults and children, although validation and refinement may be necessary.

  2. Radioanalytical Data Quality Objectives and Measurement Quality Objectives during a Federal Radiological Monitoring and Assessment Center Response

    SciTech Connect

    E. C. Nielsen

    2006-01-01

    During the early and intermediate phases of a nuclear or radiological incident, the Federal Radiological Monitoring and Assessment Center (FRMAC) collects environmental samples that are analyzed by organizations with radioanalytical capability. Resources dedicated to quality assurance (QA) activities must be sufficient to assure that appropriate radioanalytical measurement quality objectives (MQOs) and assessment data quality objectives (DQOs) are met. As the emergency stabilizes, QA activities will evolve commensurate with the need to reach appropriate DQOs. The MQOs represent a compromise between precise analytical determinations and the timeliness necessary for emergency response activities. Minimum detectable concentration (MDC), lower limit of detection, and critical level tests can all serve as measurements reflecting the MQOs. The relationship among protective action guides (PAGs), derived response levels (DRLs), and laboratory detection limits is described. The rationale used to determine the appropriate laboratory detection limit is described.

  3. [Clinical and radiological study on tissue regeneration after alveolar bone augmentation with various osteoplastic materials and membranes].

    PubMed

    Mikhaĭlovskiĭ, A A; Kulakov, A A; Korolev, V M; Vinnichenko, O Iu

    2014-01-01

    The aim of the study was to compare the efficiency of alveolar bone augmentation using a variety of osteoplastic materials and collagen membrane and healing under a clot. The study included patients undergoing the extraction of symmetric teeth. After extraction one of the sockets were filled with osteoplastic materials while symmetrically located socket with no bone grafting served as a control. In group 1 augmentation was performed using Bio-Oss Collagen Bio-Gide membrane, in group 2 - Osteodent-M and Collost membranes, in group 3 - BIOPLAST-dent and BIOPLAST-dent-MK membranes. Clinical and radiological evaluation revealed positive impact of bioplastic materials on the bone tissue healing and recovery rates. The best results showed Bio-Oss Collagen with barrier bioresorbable membrane Bio-Gide allowing the creation of the most favorable conditions for delayed implantation. PMID:25377579

  4. Clinical, laboratory and radiological parameters in children with dengue fever and predictive factors for dengue shock syndrome.

    PubMed

    Chacko, Betty; Subramanian, Gayathri

    2008-04-01

    This article is a prospective study of the clinical, laboratory and radiological picture of children satisfying the case definition criteria of dengue by WHO admitted at Sri Ramachandra Medical College and Research Institute, a suburban tertiary referral centre, to determine the predictive factors for dengue shock syndrome (DSS). Data were analyzed by Chi-squared test and Student's t-test for significance after dividing the patients into two groups, those with and those without DSS for the same. Bleeding manifestations, presence of effusion on USG/X-ray, haematocrit >35%, WBC <4000/cumm, Na < or =130 meq/l, bicarbonate level of <18 mmol/l, deranged coagulation profile and serum glutamic pyruvic transaminase (SGPT) > or =40 IU were predictive of DSS.

  5. Histopathological study of the outer membrane of the dura mater in chronic sub dural hematoma: Its clinical and radiological correlation

    PubMed Central

    Bokka, Sriharsha; Trivedi, Adarsh

    2016-01-01

    Background: A chronic subdural hematoma is an old clot of blood on the surface of the brain between dura and arachnoid membranes. These liquefied clots most often occur in patients aged 60 and older with brain atrophy. When the brain shrinks inside the skull over time, minor head trauma can cause tearing of blood vessels over the brain surface, resulting in a slow accumulation of blood over several days to weeks. Aim of the Study: To evaluate the role of membrane in hematoma evaluation and to correlate its histopathology with clinic-radiological aspects of the condition and overall prognosis of patients. Material and Methods: The study incorporated all cases of chronic SDH admitted to the Neurosurgery department of JLN Hospital and Research Centre, Bhilai, between November 2011 and November 2013. All such cases were analyzed clinically, radiologically like site, size, thickness in computed tomography, the attenuation value, midline shift and histopathological features were recorded. Criteria for Inclusion: All cases of chronic subdural haematoma irrespective of age and sex were incorporated into the study. Criteria for Exclusion: All cases of acute subdural haematoma and cases of chronic sub dural hematoma which were managed conservatively irrespective of age and sex were excluded from the study Results: In our series of cases, the most common histopathological type of membrane was the inflammatory membrane (Type II) seen in 42.30% of cases followed by hemorrhagic inflammatory membrane (Type III) seen in 34.62% of cases while scar inflammatory type of membrane (Type IV) was seen in 23.08% of cases. No case with noninflammatory type (Type I) was encountered. PMID:26889276

  6. Error in radiology.

    PubMed

    Goddard, P; Leslie, A; Jones, A; Wakeley, C; Kabala, J

    2001-10-01

    The level of error in radiology has been tabulated from articles on error and on "double reporting" or "double reading". The level of error varies depending on the radiological investigation, but the range is 2-20% for clinically significant or major error. The greatest reduction in error rates will come from changes in systems.

  7. Novel Somatic Mutations in Primary Hyperaldosteronism are related to the Clinical, Radiological and Pathological Phenotype

    PubMed Central

    Scholl, Ute I.; Healy, James M.; Thiel, Anne; Fonseca, Annabelle L.; Brown, Taylor C.; Kunstman, John W.; Horne, Matthew J.; Dietrich, Dimo; Riemer, Jasmin; Kücükköylü, Seher; Reimer, Esther N.; Reis, Anna-Carinna; Goh, Gerald; Kristiansen, Glen; Mahajan, Amit; Korah, Reju; Lifton, Richard P.; Prasad, Manju L.; Carling, Tobias

    2016-01-01

    Summary Aldosterone-producing adenomas (APAs) and bilateral adrenal hyperplasia are important causes of secondary hypertension. Somatic mutations in KCNJ5, CACNA1D, ATP1A1, ATP2B3 and CTNNB1 have been described in APAs. Objective To characterize clinical-pathological features in APAs and unilateral adrenal hyperplasia, and correlate them with genotypes. Design Retrospective study. Subjects and Measurements Clinical and pathological characteristics of 90 APAs and 7 diffusely or focally hyperplastic adrenal glands were reviewed, and samples were examined for mutations in known disease genes by Sanger or exome sequencing. Results Mutation frequencies were: KCNJ5, 37.1%; CACNA1D, 10.3%; ATP1A1, 8.2%; ATP2B3, 3.1%; CTNNB1, 2.1%. Previously unidentified mutations included I157K, F154C and 2 insertions (I150_G151insM and I144_E145insAI) in KCNJ5, all close to the selectivity filter, V426G_V427Q_A428_L433del in ATP2B3, and A39Efs*3 in CTNNB1. Mutations in KCNJ5 were associated with female, and other mutations with male gender (p=0.007). On computed tomography, KCNJ5-mutant tumors displayed significantly greater diameter (p=0.023), calculated area (p=0.002) and lower pre-contrast Hounsfield Units (p=0.0002) vs. tumors with mutations in other genes. Accordingly, KCNJ5-mutant tumors were predominantly comprised of lipid-rich fasciculata-like clear cells, whereas other tumors were heterogeneous (p=5×10−6 vs. non-KCNJ5 mutant and p=0.0003 vs. wild type tumors, respectively). CACNA1D mutations were present in two samples with hyperplasia without adenoma. Conclusions KCNJ5 mutant tumors appear to be associated with fasciculata-like clear cell predominant histology and tend to be larger with a characteristic imaging phenotype. Novel somatic KCNJ5 variants likely cause adenomas by loss of potassium selectivity, similar to previously described mutations. PMID:26252618

  8. Measuring informant discrepancies in clinical child research.

    PubMed

    De Los Reyes, Andres; Kazdin, Alan E

    2004-09-01

    Discrepancies among informants' ratings of child psychopathology have important implications for diagnosis, assessment, and treatment. Typically, parents and children complete measures (e.g., self-report checklists, diagnostic instruments) to assess child dysfunction. Ratings gathered from these sources reveal relatively little agreement on the nature and extent of the child's social, emotional, and behavioral problems. This article reviews and illustrates the most frequently used methods of measuring informant discrepancies in the clinical child literature (i.e., raw difference, standardized difference, and residual difference scores) and outlines key considerations to influence their selection. The authors conclude that frequently used methods of measuring informant discrepancies are not interchangeable and recommend that future investigations examining informant discrepancies in clinical child research use the standardized difference score as their measure of informant discrepancies.

  9. Clinical outcome measures for Cutaneous Lupus Erythematosus

    PubMed Central

    Albrecht, Joerg; Werth, Victoria P.

    2011-01-01

    Cutaneous lupus erythematosus is a clinically heterogeneous group of rare skin diseases that only rarely have been subjected to controlled clinical trials. This may be have been partly due to a lack of suitable validated outcome instruments. Recently the FDA mandated that organ specific trials for lupus erythematosus need to use a combination of different outcome measures. The patient’s condition needs to be assessed in terms of quality of life, the patient’s global response and organ specific instruments that measure activity of the disease as well as damage due to the disease. For the skin the only formally validated and published instrument is currently the Cutaneous Lupus Erythematosis Disease Area and Severity Index (CLASI). This paper discusses the background of the development of the CLASI as well as issues related to its use and interpretation in the context of clinical research of CLE. PMID:20693208

  10. Clinical and Radiological Outcomes of Segmental Spinal Fusion in Transforaminal Lumbar Interbody Fusion with Spinous Process Tricortical Autograft

    PubMed Central

    Tangviriyapaiboon, Teera

    2014-01-01

    Study Design A retrospective study. Purpose To investigate clinical and radiological outcomes when using spinous process as a tricortical autograft for segmental spinal fusion in transforaminal lumbar interbody fusion (TLIF). Overview of Literature Interbody spinal fusion is one of the important procedures in spinal surgery. Many types of autografts are harvested at the expense of complications. Clinical and radiographic results of patients who underwent TLIF with intraoperative harvested spinous process autograft in Prasat Neurological Institue, Bangkok, Thailand, were assessed as new technical innovation. Methods Between October 2005 to July 2009, 30 cases of patients who underwent TLIF with spinous process tricortical autograft were included. Clinical evaluations were assessed by visual analog scales (VAS) and Prolo functional and economic scores at the preoperation and postoperation and at 2 years postoperation. Static and dynamic plain radiograph of lumbar spine were reviewed for achievement of fusion. Results Initial successful fusion time in lumbar interbody fusion with spinous process tricortical autograft was 4.72 months (range, 3.8-6.1 months) postoperation and 100% fusion rate was reported at 2 years. Our initial successful fusion time in lumbar interbody fusion was compared to the other types of grafts in previous literatures. Conclusions The use of intraoperative harvested spinous process tricortical autograft has overcome many disadvantages of harvesting autograft with better initial successful fusion time (4.72 months). VAS and Prolo scores showed some improvement in the outcomes between the preoperative and postoperative periods. PMID:24761199

  11. Clinical and radiological characteristics of 17 Chinese patients with pathology confirmed tumefactive demyelinating diseases: follow-up study.

    PubMed

    Yao, Jiarui; Huang, Dehui; Gui, Qiuping; Chen, Xiaolei; Lou, Xin; Wu, Lei; Cheng, Chen; Li, Jie; Wu, Weiping

    2015-01-15

    Tumefactive demyelinating disease is a rare inflammatory demyelinating disease (IDD) of the central nervous system (CNS). The literature lacks a clear and consistent description of the clinical and radiological spectrum of this disorder, and few Chinese cases have been studied. Here we report 17 Chinese patients, with pathology confirmed CNS IDD, who had distinct clinical and imaging features from those in previous reports. Median age at onset was 47 years, with a female to male ratio of 1.1:1. Multifocal lesions were present in nine cases (53%) on their pre-biopsy magnetic resonance imagings (MRIs), with locations predominantly involving periventricular white matter (41%), subcortical white matter (41%), juxtacortical regions (41%), and cortical gray matter (35%). Moderate to severe perilesional edema and/or mass effect were present in 35% of cases. A variety of enhancement patterns were observed; most were heterogeneous, including ring-like, patchy, venular-like, nodular, punctate, and diffuse in a decreased frequency. Perilesional restriction on diffusion-weighted images (DWI) were evident in 70% cases. Clinical course prior to biopsy was a first neurological event in 82% cases. During a median follow-up of 4.1 years, 76% of cases remained as isolated demyelinating syndrome, and 70% experienced a total or near-total recovery regardless of whether they received immunotherapy. Further studies are needed, especially concerning series with pathological confirmation and long-term follow-up information.

  12. Radiotherapy treatment verification using radiological thickness measured with an amorphous silicon electronic portal imaging device: Monte Carlo simulation and experiment

    NASA Astrophysics Data System (ADS)

    Kairn, T.; Cassidy, D.; Sandford, P. M.; Fielding, A. L.

    2008-07-01

    This work validates the use of an amorphous-silicon, flat-panel electronic portal imaging device (a-Si EPID) for use as a gauge of patient or phantom radiological thickness, as an alternative to dosimetry. The response of the a-Si EPID is calibrated by adapting a technique previously applied to scanning liquid ion chamber EPIDs, and the stability, accuracy and reliability of this calibration are explored in detail. We find that the stability of this calibration, between different linacs at the same centre, is sufficient to justify calibrating only one of the EPIDs every month and using the calibration data thus obtained to perform measurements on all of the other linacs. Radiological thickness is shown to provide a reliable means of relating experimental measurements to the results of BEAMnrc Monte Carlo simulations of the linac-phantom-EPID system. For these reasons we suggest that radiological thickness can be used to verify radiotherapy treatment delivery and identify changes in the treatment field, patient position and target location, as well as patient physical thickness.

  13. Work Productivity in Rheumatoid Arthritis: Relationship with Clinical and Radiological Features

    PubMed Central

    Chaparro del Moral, Rafael; Rillo, Oscar Luis; Casalla, Luciana; Morón, Carolina Bru; Citera, Gustavo; Cocco, José A. Maldonado; Correa, María de los Ángeles; Buschiazzo, Emilio; Tamborenea, Natalia; Mysler, Eduardo; Tate, Guillermo; Baños, Andrea; Herscovich, Natalia

    2012-01-01

    Objective. To assess the relationship between work productivity with disease activity, functional capacity, life quality and radiological damage in patients with rheumatoid arthritis (RA). Methods. The study included consecutive employed patients with RA (ACR'87), aged over 18. Demographic, disease-related, and work-related variables were determined. The reduction of work productivity was assessed by WPAI-RA. Results. 90 patients were evaluated, 71% women. Age average is 50 years old, DAS28 4, and RAQoL 12. Median SENS is 18 and HAQ-A 0.87. Mean absenteeism was of 14%, presenting an average of 6.30 work hours wasted weekly. The reduction in performance at work or assistance was of 38.4% and the waste of productivity was of 45%. Assistance correlated with DAS28 (r = 0.446; P < 0.001), HAQ-A (r = 0.545; P < 0.001) and RAQoL (r = 0.475; P < 0.001). Lower total productivity was noticed in higher levels of activity and functional disability. Patients with SENS > 18 showed lower work productivity than those with SENS < 18 (50 versus 34; P = 0.04). In multiple regression analysis, variables associated with reduction of total work productivity were HAQ-A and RAQoL. Conclusion. RA patients with higher disease severity showed higher work productivity compromise. PMID:23320166

  14. Image processing, radiological, and clinical information fusion in breast cancer detection

    NASA Astrophysics Data System (ADS)

    Alto, Hilary; Rangayyan, Rangaraj M.; Solaiman, Basel; Desautels, J. E. Leo; MacGregor, J. H.

    2002-03-01

    Screening mammography is the most efficient and cost-effective method available for detecting the signs of early breast cancer in asymptomatic women between the ages of 50 and 69. To improve the detection rate and reduce the number of unnecessary biopsies, many different computer-aided diagnosis techniques have been developed. Many of these techniques use image processing algorithms to automatically segment and classify the images. The decision-making process associated with the evaluation of mammograms is complex and incorporates multiple sources of information from standard medical knowledge and radiology to pathology. The use of this information combined with the results of image processing offers new challenges to the field of data and information fusion. In this paper, we describe the different information sources and their data as well as the framework that is needed to support this type of fusion. A database of breast cancer screening cases forms the basis of the resulting fusion model. The database and decision-level fusion techniques will facilitate unique and specialized approaches for efficient and sophisticated diagnosis of breast cancer.

  15. Benefits of hospital-wide PACS networks: a survey of clinical users of radiology services

    NASA Astrophysics Data System (ADS)

    Bryan, Stirling; Weatherburn, Gwyneth C.; Watkins, Jessamy; Buxton, Martin J.

    1998-07-01

    An independent evaluation of PACS has been carried out at Hammersmith Hospital. This paper describes one element: the use of a questionnaire instrument to assess radiology service user's views on the quality of the service being provided; major causes of dissatisfaction with the service; the extent to which images are unavailable; and the consequences of images unavailability. The objective was to investigate some of the key claims made for the PACS technology. The principal research design was a 'before and after' comparison at Hammersmith Hospital. A number of other, comparator, hospitals were included in this survey in order to allow inferences to be made about the any observed changes at Hammersmith. The questionnaire was distributed on three occasions before PACS was operational at Hammersmith and on one occasion afterwards. Across all data collection rounds and all sites, very high levels of satisfaction with image quality were reported. When asked about satisfaction with the written reporting service, a larger proportion of respondents across all sites and rounds indicated their discontent Following the introduction of PACS, the proportion of respondents indicating that lost ward or outpatient images was a problem was significantly lower and the rate of re-examination was lower.

  16. Measuring Mortality Information in Clinical Data Warehouses.

    PubMed

    Jones, Barrett; Vawdrey, David K

    2015-01-01

    The ability to track and report long-term outcomes, especially mortality, is essential for advancing clinical research. The purpose of this study was to present a framework for assessing the quality of mortality information in clinical research databases. Using the clinical data warehouse (CDW) at Columbia University Medical Center as a case study, we measured: 1) agreement in vital status between our institution's patient registration system and the U.S. Social Security Administration's Death Master File (DMF), 2) the proportion of patients marked as deceased according to the DMF records who had subsequent visits to our institution, and 3) the proportion of patients still living according to Columbia's CDW who were over 100 and 120 years of age. Of 33,295 deaths recorded in our institution's patient registration system, 13,167 (39.5%) did not exist in the DMF. Of 315,037 patients in our CDW who marked as deceased according to the DMF, 2.1% had a subsequent clinical encounter at our institution. The proportion of patients still living according to Columbia's CDW who were over 100 and 120 years of age was 43.6% and 43.1%, respectively. These measures may be useful to other clinical research investigators seeking to assess the quality of mortality data (1-4). PMID:26306284

  17. Measuring Mortality Information in Clinical Data Warehouses

    PubMed Central

    Jones, Barrett; Vawdrey, David K.

    2015-01-01

    The ability to track and report long-term outcomes, especially mortality, is essential for advancing clinical research. The purpose of this study was to present a framework for assessing the quality of mortality information in clinical research databases. Using the clinical data warehouse (CDW) at Columbia University Medical Center as a case study, we measured: 1) agreement in vital status between our institution’s patient registration system and the U.S. Social Security Administration’s Death Master File (DMF), 2) the proportion of patients marked as deceased according to the DMF records who had subsequent visits to our institution, and 3) the proportion of patients still living according to Columbia’s CDW who were over 100 and 120 years of age. Of 33,295 deaths recorded in our institution’s patient registration system, 13,167 (39.5%) did not exist in the DMF. Of 315,037 patients in our CDW who marked as deceased according to the DMF, 2.1% had a subsequent clinical encounter at our institution. The proportion of patients still living according to Columbia’s CDW who were over 100 and 120 years of age was 43.6% and 43.1%, respectively. These measures may be useful to other clinical research investigators seeking to assess the quality of mortality data (1–4). PMID:26306284

  18. Measuring Mortality Information in Clinical Data Warehouses.

    PubMed

    Jones, Barrett; Vawdrey, David K

    2015-01-01

    The ability to track and report long-term outcomes, especially mortality, is essential for advancing clinical research. The purpose of this study was to present a framework for assessing the quality of mortality information in clinical research databases. Using the clinical data warehouse (CDW) at Columbia University Medical Center as a case study, we measured: 1) agreement in vital status between our institution's patient registration system and the U.S. Social Security Administration's Death Master File (DMF), 2) the proportion of patients marked as deceased according to the DMF records who had subsequent visits to our institution, and 3) the proportion of patients still living according to Columbia's CDW who were over 100 and 120 years of age. Of 33,295 deaths recorded in our institution's patient registration system, 13,167 (39.5%) did not exist in the DMF. Of 315,037 patients in our CDW who marked as deceased according to the DMF, 2.1% had a subsequent clinical encounter at our institution. The proportion of patients still living according to Columbia's CDW who were over 100 and 120 years of age was 43.6% and 43.1%, respectively. These measures may be useful to other clinical research investigators seeking to assess the quality of mortality data (1-4).

  19. Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury.

    PubMed

    Calvo, Emilio; López-Franco, Mariano; Arribas, Ignacio M

    2006-01-01

    The management of acute acromioclavicular joint dislocations is controversial. The purpose of this study was to compare the incidence of posttraumatic anatomic alterations after surgical or conservative treatment of type III injuries and to analyze their effect on the outcome. Forty-three patients were evaluated retrospectively, clinically and radiographically, at a 12-month minimum follow-up. Thirty-two were treated surgically, using the Phemister technique, and 11 had conservative treatment. A comparison of the overall clinical results in both groups showed no statistically significant differences. The acromioclavicular joint was anatomically reduced in only half of the surgical patients. Those shoulders treated surgically showed a significantly higher incidence of osteoarthritis and coracoclavicular ligament ossification. Differences in clavicular deformity or osteolysis were not significant. None of these abnormalities had any influence on the clinical result. Because operative and conservative treatments achieve equally good clinical results and surgery carries a higher risk of osteoarthritis, we recommend managing this injury conservatively.

  20. Clinical and Radiological Evaluation of Cleidocranial Dysplasia in Two Trinidadian Siblings

    PubMed Central

    Bissoon, AK; Moze, K

    2014-01-01

    ABSTRACT Cleidocranial dysplasia is a rare developmental disorder of the skeleton and teeth that may be inherited as an autosomal dominant trait or occur spontaneously. This is a report of two Trinidadian, East Indian brothers aged 13 and 15 years referred from a private dental practice with the chief complaint of retained deciduous teeth. Subsequent clinical and radiographic investigations led to the diagnosis of cleidocranial dysplasia. The clinical and radiographic findings are discussed. PMID:25781294

  1. Clinical and radiological observations in a case series of 26 patients with fibrous dysplasia.

    PubMed

    Thomsen, Malissa Dawn; Rejnmark, Lars

    2014-04-01

    Fibrous dysplasia (FD) is a rare disease caused by a sporadic postzygotic missense mutation that leads to abnormal fibroblast proliferation, defective osteoblast differentiation, and increased bone resorption. It may affect one or several bones. Both the mono-ostotic and polyostotic types may be associated with hyperfunctional endocrinopathies and hyperpigmentation of the skin (café-au-lait spots) in the so-called McCune-Albright syndrome (MAS). Due to its rarity, only a few case series are available, making it difficult for most clinicians to judge the severity of the disease. To improve our knowledge of FD, we reviewed all cases of FD treated at our department of endocrinology. Among 26 patients, 17 (65 %) had polyostotic FD, with four being diagnosed with MAS. Patients with polyostotic FD were diagnosed at an earlier age (median 13, range 0.5-64 years) than patients with the mono-ostotic form (median 21, 1-70 years). Craniofacial bones were affected in 80 % of cases, and 66 % complained of bone pain at the affected site, with no difference between patients with mono- and polyostotic FD. Two patients with mono-ostotic and three with polyostotic FD had cranial nerve impairments. Fourteen underwent, at least, one surgery, six (67 %) with mono-ostotic and eight (47 %) with polyostotic FD. Most received treatment with bisphosphonates, but therapy did not result in any clear relief of symptoms or radiological improvements. In conclusion, bone pain is common in patients with FD. The severity of the disease depends on affected bones as mono-ostotic may be as debilitating as polyostotic FD. In our case series, bisphosphonate treatment did not show clear beneficial effects.

  2. Measurements of radiological data of some amino acids in the energy range 0.122-1.330MeV

    NASA Astrophysics Data System (ADS)

    Lokhande, Rajkumar M.; More, Chaitali V.; Surung, Bharat S.; Raut, Siddheshwar D.; Pawar, Pravina P.

    2016-05-01

    Radiological parameters such as μm, σt, σe, Zeff and Neff of amino acids, namely Lysine (C6H15N2O2), Histidine (C6H9N3O2) and Arginine (C6H15N4O2), were measured using NaI (Tl)-based gamma spectrometry. Radioactive sources used in the study are 57Co, 133Ba, 137Cs, 54Mn, 60Co and 22Na. Gamma ray transmission method in a narrow beam good geometry set up was used in the study. The measured data were compared against XCOM-based data. The agreement is within 2%.

  3. Impact on Patient Safety and Satisfaction of Implementation of an Outpatient Clinic in Interventional Radiology (IPSIPOLI-Study): A Quasi-Experimental Prospective Study

    SciTech Connect

    Lutjeboer, Jacob Burgmans, Mark Christiaan E-mail: mburgmans@hotmail.com; Chung, Kaman Erkel, Arian Robert van

    2015-06-15

    PurposeInterventional radiology (IR) procedures are associated with high rates of preparation and planning errors. In many centers, pre-procedural consultation and screening of patients is performed by referring physicians. Interventional radiologists have better knowledge about procedure details and risks, but often only get acquainted with the patient in the procedure room. We hypothesized that patient safety (PS) and patient satisfaction (PSAT) in elective IR procedures would improve by implementation of a pre-procedural visit to an outpatient IR clinic.Material and MethodsIRB approval was obtained and informed consent was waived. PS and PSAT were measured in patients undergoing elective IR procedures before (control group; n = 110) and after (experimental group; n = 110) implementation of an outpatient IR clinic. PS was measured as the number of process deviations. PSAT was assessed using a questionnaire measuring Likert scores of three dimensions: interpersonal care aspects, information/communication, and patient participation. Differences in PS and PSAT between the two groups were compared using an independent t test.ResultsThe average number of process deviations per patient was 0.39 in the control group compared to 0.06 in the experimental group (p < 0.001). In 9.1 % patients in the control group, no legal informed consent was obtained compared to 0 % in the experimental group. The mean overall Likert score was significantly higher in the experimental group compared to the control group: 2.68 (SD 0.314) versus 2.48 (SD 0.381) (p < 0.001).ConclusionPS and PSAT improve significantly if patients receive consultation and screening in an IR outpatient clinic prior to elective IR procedures.

  4. A case of interstitial lung disease associated with clinically amyopathic dermatomyositis: radiologic-pathologic correlation.

    PubMed

    Okubo, Gosuke; Noma, Satoshi; Nishimoto, Yuko; Sada, Ryuichi; Kobashi, Yoichiro

    2013-01-01

    This case report describes a 64-year-old woman with interstitial lung disease associated with clinically amyopathic dermatomyositis. Chest computed tomography revealed consolidations along bronchovascular bundles in the periphery of the lower lungs. Interstitial lung disease developed acutely, and the patient died 3 months after the clinical diagnosis. An autopsy was performed, and a large section of the lung specimen was prepared. Various interstitial lesions including organizing pneumonia, cellular and fibrotic nonspecific interstitial pneumonia, and diffuse alveolar damage were seen in the large section. Correlating the large section and computed tomography images was useful for determining the distribution of diffuse alveolar damage.

  5. Comparison of structural allograft and traditional autograft technique in occipitocervical fusion: radiological and clinical outcomes from a single institution.

    PubMed

    Godzik, Jakub; Ravindra, Vijay M; Ray, Wilson Z; Schmidt, Meic H; Bisson, Erica F; Dailey, Andrew T

    2015-08-01

    OBJECT The authors' objectives were to compare the rate of fusion after occipitoatlantoaxial arthrodesis using structural allograft with the fusion rate from using autograft, to evaluate correction of radiographic parameters, and to describe symptom relief with each graft technique. METHODS The authors assessed radiological fusion at 6 and 12 months after surgery and obtained radiographic measurements of C1-2 and C2-7 lordotic angles, C2-7 sagittal vertical alignments, and posterior occipitocervical angles at preoperative, postoperative, and final follow-up examinations. Demographic data, intraoperative details, adverse events, and functional outcomes were collected from hospitalization records. Radiological fusion was defined as the presence of bone trabeculation and no movement between the graft and the occiput or C-2 on routine flexion-extension cervical radiographs. Radiographic measurements were obtained from lateral standing radiographs with patients in the neutral position. RESULTS At the University of Utah, 28 adult patients underwent occipitoatlantoaxial arthrodesis between 2003 and 2010 using bicortical allograft, and 11 patients were treated using iliac crest autograft. Mean follow-up for all patients was 20 months (range 1-108 months). Of the 27 patients with a minimum of 12 months of follow-up, 18 (95%) of 19 in the allograft group and 8 (100%) of 8 in the autograft group demonstrated evidence of bony fusion shown by imaging. Patients in both groups demonstrated minimal deterioration of sagittal vertical alignment at final follow-up. Operative times were comparable, but patients undergoing occipitocervical fusion with autograft demonstrated greater blood loss (316 ml vs 195 ml). One (9%) of 11 patients suffered a significant complication related to autograft harvesting. CONCLUSIONS The use of allograft in occipitocervical fusion allows a high rate of successful arthrodesis yet avoids the potentially significant morbidity and pain associated with

  6. De-identification of clinical narratives through writing complexity measures

    PubMed Central

    Li, Muqun; Carrell, David; Aberdeen, John; Hirschman, Lynette; Malin, Bradley A.

    2014-01-01

    Purpose Electronic health records contain a substantial quantity of clinical narrative, which is increasingly reused for research purposes. To share data on a large scale and respect privacy, it is critical to remove patient identifiers. De-identification tools based on machine learning have been proposed; however, model training is usually based on either a random group of documents or a pre-existing document type designation (e.g., discharge summary). This work investigates if inherent features, such as the writing complexity, can identify document subsets to enhance de-identification performance. Methods We applied an unsupervised clustering method to group two corpora based on writing complexity measures: a collection of over 4500 documents of varying document types (e.g., discharge summaries, history and physical reports, and radiology reports) from Vanderbilt University Medical Center (VUMC) and the publicly available i2b2 corpus of 889 discharge summaries. We compare the performance (via recall, precision, and F-measure) of de-identification models trained on such clusters with models trained on documents grouped randomly or VUMC document type. Results For the Vanderbilt dataset, it was observed that training and testing de-identification models on the same stylometric cluster (with the average F-measure of 0.917) tended to outperform models based on clusters of random documents (with an average F-measure of 0.881). It was further observed that increasing the size of a training subset sampled from a specific cluster could yield improved results (e.g., for subsets from a certain stylometric cluster, the F-measure raised from 0.743 to 0.841 when training size increased from 10 to 50 documents, and the F-measure reached 0.901 when the size of the training subset reached 200 documents). For the i2b2 dataset, training and testing on the same clusters based on complexity measures (average F-score 0.966) did not significantly surpass randomly selected clusters

  7. Machine learning and radiology.

    PubMed

    Wang, Shijun; Summers, Ronald M

    2012-07-01

    In this paper, we give a short introduction to machine learning and survey its applications in radiology. We focused on six categories of applications in radiology: medical image segmentation, registration, computer aided detection and diagnosis, brain function or activity analysis and neurological disease diagnosis from fMR images, content-based image retrieval systems for CT or MRI images, and text analysis of radiology reports using natural language processing (NLP) and natural language understanding (NLU). This survey shows that machine learning plays a key role in many radiology applications. Machine learning identifies complex patterns automatically and helps radiologists make intelligent decisions on radiology data such as conventional radiographs, CT, MRI, and PET images and radiology reports. In many applications, the performance of machine learning-based automatic detection and diagnosis systems has shown to be comparable to that of a well-trained and experienced radiologist. Technology development in machine learning and radiology will benefit from each other in the long run. Key contributions and common characteristics of machine learning techniques in radiology are discussed. We also discuss the problem of translating machine learning applications to the radiology clinical setting, including advantages and potential barriers.

  8. Machine Learning and Radiology

    PubMed Central

    Wang, Shijun; Summers, Ronald M.

    2012-01-01

    In this paper, we give a short introduction to machine learning and survey its applications in radiology. We focused on six categories of applications in radiology: medical image segmentation, registration, computer aided detection and diagnosis, brain function or activity analysis and neurological disease diagnosis from fMR images, content-based image retrieval systems for CT or MRI images, and text analysis of radiology reports using natural language processing (NLP) and natural language understanding (NLU). This survey shows that machine learning plays a key role in many radiology applications. Machine learning identifies complex patterns automatically and helps radiologists make intelligent decisions on radiology data such as conventional radiographs, CT, MRI, and PET images and radiology reports. In many applications, the performance of machine learning-based automatic detection and diagnosis systems has shown to be comparable to that of a well-trained and experienced radiologist. Technology development in machine learning and radiology will benefit from each other in the long run. Key contributions and common characteristics of machine learning techniques in radiology are discussed. We also discuss the problem of translating machine learning applications to the radiology clinical setting, including advantages and potential barriers. PMID:22465077

  9. Burkitt's lymphoma: a child's case presenting in the maxilla. Clinical and radiological aspects.

    PubMed

    Valenzuela-Salas, Borja; Dean-Ferrer, Alicia; Alamillos-Granados, Francisco-Jesús

    2010-05-01

    Burkitt's lymphoma (BL) is a neoplasm which, despite its very aggressive behaviour is potentially curable. It typically affects the paediatric population. BL belongs to the non-Hodgkin lymphomas group, and is the first human tumour undoubtedly related to a viral origin (Epstein-Barr virus). Two main clinical subtypes are recognized: endemic or African type, and sporadic type; HIV associated BL constitutes a third type. Although common in endemic BL, maxillary involvement is rare in sporadic cases. This, together with the clinical lack of specificity associated to this location, makes diagnosis difficult. New chemotherapeutic protocols achieve a high survival rate. Most important prognostic factors are location and tumour stage. We report a paediatric case of BL presenting in the maxilla, with a review and a description of the characteristics of the disease.

  10. Nevoid Basal Cell Carcinoma Syndrome - Clinical and Radiological Findings of Three Cases

    PubMed Central

    Ali, Ibrahim K; Karjodkar, Freny R; Sansare, Kaustubh; Salve, Prashant; Goyal, Shikha

    2016-01-01

    Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder, characterized by skeletal anomalies and multiple keratocystic odontogenic tumors of the jaws. The skeletal anomalies of this syndrome are mandibular prognathism, bossing of frontal and parietal bones, high-arched palate, and bifid rib. We report three cases with NBCCS, emphasizing the clinical and radiographic findings, the importance of the early diagnosis of NBCCS, and a preventive multidisciplinary approach in the management of NBCCS.

  11. Nevoid Basal Cell Carcinoma Syndrome - Clinical and Radiological Findings of Three Cases

    PubMed Central

    Ali, Ibrahim K; Karjodkar, Freny R; Sansare, Kaustubh; Salve, Prashant; Goyal, Shikha

    2016-01-01

    Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder, characterized by skeletal anomalies and multiple keratocystic odontogenic tumors of the jaws. The skeletal anomalies of this syndrome are mandibular prognathism, bossing of frontal and parietal bones, high-arched palate, and bifid rib. We report three cases with NBCCS, emphasizing the clinical and radiographic findings, the importance of the early diagnosis of NBCCS, and a preventive multidisciplinary approach in the management of NBCCS. PMID:27630800

  12. Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

    PubMed

    Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

    2010-03-01

    Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes.

  13. Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

    PubMed

    Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

    2010-03-01

    Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes. PMID:20067999

  14. Measuring pacemaker dose: A clinical perspective

    SciTech Connect

    Studenski, Matthew T.; Xiao Ying; Harrison, Amy S.

    2012-07-01

    Recently in our clinic, we have seen an increased number of patients presenting with pacemakers and defibrillators. Precautions are taken to develop a treatment plan that minimizes the dose to the pacemaker because of the adverse effects of radiation on the electronics. Here we analyze different dosimeters to determine which is the most accurate in measuring pacemaker or defibrillator dose while at the same time not requiring a significant investment in time to maintain an efficient workflow in the clinic. The dosimeters analyzed here were ion chambers, diodes, metal-oxide-semiconductor field effect transistor (MOSFETs), and optically stimulated luminescence (OSL) dosimeters. A simple phantom was used to quantify the angular and energy dependence of each dosimeter. Next, 8 patients plans were delivered to a Rando phantom with all the dosimeters located where the pacemaker would be, and the measurements were compared with the predicted dose. A cone beam computed tomography (CBCT) image was obtained to determine the dosimeter response in the kilovoltage energy range. In terms of the angular and energy dependence of the dosimeters, the ion chamber and diode were the most stable. For the clinical cases, all the dosimeters match relatively well with the predicted dose, although the ideal dosimeter to use is case dependent. The dosimeters, especially the MOSFETS, tend to be less accurate for the plans, with many lateral beams. Because of their efficiency, we recommend using a MOSFET or a diode to measure the dose. If a discrepancy is observed between the measured and expected dose (especially when the pacemaker to field edge is <10 cm), we recommend analyzing the treatment plan to see whether there are many lateral beams. Follow-up with another dosimeter rather than repeating multiple times with the same type of dosimeter. All dosimeters should be placed after the CBCT has been acquired.

  15. The Ability of the United States Federal Radiological Monitoring and Assessment Center to Collect and Disseminate Environmental Measurements during Radiological Emergencies

    SciTech Connect

    Craig Marianno and James Essex

    2007-04-30

    The Federal Radiological Monitoring and Assessment Center (FRMAC) is the United States’ response organization for radiological emergencies. The FRMAC is structured as an operations center and employs the combined resources of several federal agencies to respond to any disaster resulting in the release of radioactivity. The mission of the FRMAC is to support state and local authorities in the gathering of environmental data using an array of survey equipment ranging from alpha probes, beta/gamma probes, and high-purity germanium (HPGe) spectroscopy to the gathering of physical samples. Once collected, the data are projected on maps to assist public officials make protective action decisions. In addition to the accumulation of data, it is the legal obligation of the FRMAC to keep archival records of all data points and their actions. During an event, it is conceivable that hundreds to thousands of sample points will be recorded over a relatively short time. It is in the interest of the federal government and public that the information collected be put to the best use as fast as possible. Toward this end, the Remote Sensing Laboratory, working under the direction of the United States Department of Energy’s National Nuclear Security Administration, is investigating the use of several technologies that will accelerate data flow from field teams to the FRMAC and, finally, distribution of data to decision makers and the public. Not only can finished data products be viewed through the internet, but the actual collection of data via “real-time” telemetry can be viewed using this same method. Data from the field will be transferred directly to the FRMAC using the MCPD (multi-path communication device). This base station receives the survey information from the field teams via Bluetooth and instantly investigates the best communication pathway to transfer data to the FRMAC. Possible paths include standalone radio, commercial cellular networks (GPRS and CDMA) and

  16. Polyarteritis nodosa presenting with clinical and radiologic features suggestive of polymyositis.

    PubMed

    Haroon, Muhammad; Bermingham, Niamh; Keohane, Catherine; Harney, Sinead

    2012-04-01

    We report a patient who presented with clinical and MRI findings suggestive of polymyositis but, in whom, muscle biopsy disclosed a strikingly different diagnosis. A 65-year-old woman presented with 3-week history of bilateral proximal muscle pain and weakness. Laboratory investigations showed markedly elevated inflammatory markers and mildly elevated muscle enzymes. MRI scans of lower limbs showed features suggestive of polymyositis. However, muscle biopsy showed features of a polyarteritis-type vasculitis affecting an intramuscular blood vessel. Our reports highlight the critical role of muscle biopsy in establishing the correct diagnosis in patients with suspected myositis.

  17. Papillary tumor of the pineal region with extended clinical and radiologic follow-up

    PubMed Central

    Shakir, Hakeem J.; Qiu, Jingxin; Prasad, Dheerendra; Mechtler, Laszlo L.; Fenstermaker, Robert A.

    2015-01-01

    Background: Papillary tumor of the pineal region (PTPR) is a rare neoplasm with only anecdotal data to guide the treatment. Results of treatment with surgery, radiation therapy, and chemotherapy have been reported to have varying degrees of success. Here we report a patient with a PTPR, who underwent subtotal resection, gamma knife stereotactic radiosurgery, and adjuvant temozolomide chemotherapy. Case Description: During 9 years of clinical and radiographic follow-up, the patient has had regression of residual tumor and remains asymptomatic. Conclusion: When gross total resection of a PTPR is not possible, treatment with gamma knife stereotactic radiosurgery and temozolomide chemotherapy may provide long-term tumor control. PMID:26539320

  18. [Pachydermoperiostosis (Touraine-Solente-Golé syndrome). Clinical and radiological differential diagnosis (author's transl)].

    PubMed

    Lubach, D; Freyschmidt, J; Bolten, D

    1981-02-01

    This report describes a patient with pachydermoperiostosis (Touraine-Solente-Golé-syndrome). This disorder is characterized by clubbing of the terminal phalanges with watchglass-like nails, enlargement of hands and feet, pachydermia and periostotic skeletal changes. The signs of pachydermia are cutis verticis et frontis gyrata, ptosis and increased skin-thickness of the palms of the hand and soles of the feet. Frequently, a hyperhidrosis of the hands and feet can be found. The differential diagnosis of clinical symptoms and changes in the bones is discussed in detail. PMID:7222891

  19. Clinical Signs of Radiologic Pneumonia in Under-Five Hypokalemic Diarrheal Children Admitted to an Urban Hospital in Bangladesh

    PubMed Central

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Ashraf, Hasan; Faruque, Abu S. G.; Bardhan, Pradip Kumar; Das, Sumon Kumar; Shahunja, K. M.; Shahid, Abu S. M. S. B.; Ahmed, Tahmeed

    2013-01-01

    Background Clinical signs of pneumonia are often veiled in under-five diarrheal children presenting with hypokalemia, making clinical diagnosis of pneumonia very difficult in such population. However, there is no published report that describes the influences of hypokalemia on the clinical signs of pneumonia in diarrheal children. Our objective was to assess the influences of hypokalemia, and their outcome in such children. Methods We prospectively enrolled all under-five diarrheal children (n = 180) admitted to the Special Care Ward of the Dhaka Hospital of icddr,b from September-December 2007 with radiological pneumonia who also had their serum potassium estimated. We compared the clinical features and outcome of the diarrheal children having pneumonia with (cases = 55) and without hypokalemia (controls = 125). Results The case-fatality among the cases was 2 times higher compared to the controls, but the difference was not statistically significant (p = 0.202). In logistic regression analysis, after adjusting for potential confounders such as age of the patient, clinical dehydration, severe wasting, abnormally sleepy, lower chest wall in-drawing, nasal flaring and inability to drink on admission, under-five diarrheal children with pneumonia who presented with nutritional edema had 3 times more risk to have hypokalemia compared to those without nutritional edema (OR = 2.76, 95% CI = 1.01–7.51) and these hypokalemic children were 64% less likely to present with fast breathing (OR = 0.36, 95% CI = 0.17–0.74). Conclusion and significance The results of our analysis are simple but may have great public health implications and underscore the importance of diligent assessment for pneumonia in under-five diarrheal children having risk of hypokalemia as in children with nutritional edema even in absence of fast breathing, a useful sign of pneumonia. This may help for early initiation of first dose of parental antibiotics along with

  20. Enchondroma versus Chondrosarcoma in Long Bones of Appendicular Skeleton: Clinical and Radiological Criteria—A Follow-Up

    PubMed Central

    Ferrer-Santacreu, Eugenio M.; Ortiz-Cruz, Eduardo J.; Díaz-Almirón, Mariana; Pozo Kreilinger, Jose Juan

    2016-01-01

    As of today two types of cartilage tumors remain a challenge even for the orthopedic oncologist: enchondroma (E), a benign tumor, and chondrosarcoma (LGC), a malignant and low aggressiveness tumor. A prospective study of 133 patients with a cartilaginous tumor of low aggressiveness in the long bones of the appendicular skeleton was done to prove this difficult differential diagnosis. Parameters including medical history and radiological and nuclear imaging were collected and compared to the result of the biopsy. A scale of aggressiveness was applied to each patient according to the number of aggressiveness episodes present. A comparison of the results of the biopsy with the initial diagnosis made by the orthopedic oncologist based solely on clinical data and imaging tests was also made. Finally, a management algorithm for these cases was proposed. A statistical significance for LGC resulted from the parameter as follows: pain on palpation, involvement of cortical in either the CT or MRI, and Tc99 bone scan uptake equal or superior to anterosuperior iliac crest. In our series, a tumor scoring 5 points or higher in the scale of aggressiveness can have 50% more chance of being LGC. When compared with the gold standard (the biopsy), surgeon's initial judgement showed a sensitivity of 73.5% and a specificity of 94.1%. PMID:27034667

  1. Lung volumes: measurement, clinical use, and coding.

    PubMed

    Flesch, Judd D; Dine, C Jessica

    2012-08-01

    Measurement of lung volumes is an integral part of complete pulmonary function testing. Some lung volumes can be measured during spirometry; however, measurement of the residual volume (RV), functional residual capacity (FRC), and total lung capacity (TLC) requires special techniques. FRC is typically measured by one of three methods. Body plethysmography uses Boyle's Law to determine lung volumes, whereas inert gas dilution and nitrogen washout use dilution properties of gases. After determination of FRC, expiratory reserve volume and inspiratory vital capacity are measured, which allows the calculation of the RV and TLC. Lung volumes are commonly used for the diagnosis of restriction. In obstructive lung disease, they are used to assess for hyperinflation. Changes in lung volumes can also be seen in a number of other clinical conditions. Reimbursement for measurement of lung volumes requires knowledge of current procedural terminology (CPT) codes, relevant indications, and an appropriate level of physician supervision. Because of recent efforts to eliminate payment inefficiencies, the 10 previous CPT codes for lung volumes, airway resistance, and diffusing capacity have been bundled into four new CPT codes. PMID:22871760

  2. Clinical and Radiological Findings of Autosomal Dominant Osteopetrosis Type II: A Case Report

    PubMed Central

    Kant, Priyanka; Sharda, Neelkamal; Bhowate, Rahul R.

    2013-01-01

    Osteopetrosis is a rare inherited genetic disease characterized by sclerosis of the skeleton caused by the absence or malfunction of osteoclasts. Three distinct forms of the disease have been recognized, autosomal dominant osteopetrosis being the most common. Autosomal dominant osteopetrosis exhibits a heterogeneous trait with milder symptoms, often at later childhood or adulthood. The aim of this case report is to present the clinical and radiographic features of a 35-year-old female patient with autosomal dominant osteopetrosis type II who exhibited features of chronic generalised periodontitis, and the radiographs revealed generalised osteosclerosis and hallmark radiographic features of ADO type II, that is, “bone-within-bone appearance” and “Erlenmeyer-flask deformity.” PMID:24260721

  3. Clinical-radiological evaluation of sequelae of stereotactic radiosurgery for intracranial arteriovenous malformations

    SciTech Connect

    Levy, R.P.; Fabrikant, J.I.; Frankel, K.A.; Phillips, M.H.; Steinberg, G.K.; Marks, M.P.; DeLaPaz, R.L.; Chuang, F.Y.S.

    1989-12-01

    Stereotactic heavy-charged-particle Bragg peak radiosurgery has been used to treat 322 patients with surgically-inaccessible intracranial vascular malformations. (The clinical results of this method for the treatment of angiographically demonstrable arteriovenous malformations (AVMs) and angiographically occult vascular malformations (AOVMs) of the brain are described in separate reports of this symposium). The great majority of patients have had an uneventful post-treatment course with satisfactory health outcomes. However, several categories of delayed sequelae of stereotactic radiosurgery have been identified, involving the vascular structures essential for the integrity of the brain tissue and the brain parenchyma directly. These categories reflect both reaction to injury and to alterations in regional hemodynamic status, and include vasogenic edema, occlusion of functional vasculature, radiation necrosis, and local or remote effects on cerebral arterial aneurysms. 10 refs., 7 figs., 1 tab.

  4. Subjective measures and clinical decision making.

    PubMed

    Delitto, A

    1989-07-01

    I have attempted to use Feinstein's model of clinimetric indexes and his criteria as a focus for further development of measures that in physical therapy are currently considered "soft" or "subjective". I feel this development will enhance the body of knowledge by objectifying a portion of clinical assessment (eg, the patient's complaints, "subjective" portion of the POMR's SOAP format) that is in tremendous need of quantification. By making these "soft" data "hard," I feel we will enhance the decision-making power of clinicians.

  5. Battlefield radiology

    PubMed Central

    Graham, R N J

    2012-01-01

    With the increasing tempo of military conflicts in the last decade, much has been learnt about imaging battlefield casualties in the acute setting. Ultrasound in the form of focused abdominal sonography in trauma (FAST) has proven invaluable in emergency triage of patients for immediate surgery. Multidetector CT allows accurate determination of battlefield trauma injuries. It permits the surgeons and anaesthetists to plan their interventions more thoroughly and to be made aware of clinically occult injuries. There are common injury patterns associated with blast injury, gunshot wounds and blunt trauma. While this body of knowledge is most applicable to the battlefield, there are parallels with peacetime radiology, particularly in terrorist attacks and industrial accidents. This pictorial review is based on the experiences of a UK radiologist deployed in Afghanistan in 2010. PMID:22806621

  6. Relationship of the sexual functions with the clinical parameters, radiological scores and the quality of life in male patients with ankylosing spondylitis.

    PubMed

    Sariyildiz, Mustafa Akif; Batmaz, Ibrahim; Dilek, Banu; Inanir, Ahmet; Bez, Yasin; Tahtasiz, Mehmet; Em, Serda; Cevik, Remzi

    2013-03-01

    The aim of this study was to explore the impact of ankylosing spondylitis (AS) and the disease-related variables on the patients' sexual function according to the International Index of Erectile Function (IIEF) scoring system. A total of 70 sexually active male AS patients and 60 healthy controls were enrolled in this study. Their demographic data were evaluated, and the pain was assessed according to the visual analogue scale (VAS). Laboratory tests were conducted in order to measure the C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) of the patients. The disease activity was evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional statement was evaluated with the help of the Bath Ankylosing Spondylitis Functional Index (BASFI) and with the scores obtained from the spinal measurements with the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Bath Ankylosing Spondylitis Radiology Index (BASRI) was used to evaluate the radiological damage. The disease-related quality of life was measured with the Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL). The anxiety and depression level of the patients was revealed through the Hospital Anxiety and Depression Scale (HADS). In comparison with the healthy control group, patients with AS had significantly lower scores in each of the 5 domains of the IIEF (p < 0.0001). The BASDAI, BASFI, BASMI, BASRI, ASQoL, HADS scores and CRP levels were negatively correlated with IIEF (p < 0.05). Orgasmic function and sexual desire scores were significantly lower in patients with peripheral arthritis (p < 0.05). No significant correlation was observed with the disease duration, smoking status, pain (VAS), and ESR levels when the total scores and the scores from the domains of IIEF were compared. The multivariate regression analyses indicated that BASFI and BASMI were independently associated with the sexual function. The sexual function is impaired in male patients

  7. Cysts and cystic lesions of the mandible: clinical and radiologic-histopathologic review.

    PubMed

    Scholl, R J; Kellett, H M; Neumann, D P; Lurie, A G

    1999-01-01

    Many lesions that occur in the mandible have a cystlike radiographic appearance. These lesions are often difficult to differentiate on the basis of their radiographic features alone. Mandibular lesions may be odontogenic or nonodontogenic. Among odontogenic lesions without mineralization, ameloblastomas, odontogenic keratocysts, and dentigerous cysts can all appear as well-defined, unilocular, well-corticated, lucent lesions that are often associated with the crowns of impacted or unerupted teeth. Most radicular cysts appear as round or pear-shaped, unilocular, lucent lesions in the periapical region. Among odontogenic lesions with mineralization, complex odontomas contain multiple masses of dental tissue and compound odontomas contain multiple teeth or toothlike structures. Odontogenic myxomas are characterized by lytic osseous changes of varying size, which may be demarcated and expansile or exhibit ill-defined borders. Nonodontogenic lesions that mimic odontogenic lesions include benign fibro-osseous lesions (conventional or juvenile ossifying fibroma, focal or periapical cemento-osseous dysplasia, florid osseous dysplasia), traumatic bone cyst, lingual salivary gland inclusion defect, central giant cell granuloma, brown tumor of hyperparathyroidism, arteriovenous malformation, and mucoepidermoid carcinoma. The clinical and radiographic features of these mandibular lesions help establish a differential diagnosis, although microscopic tissue evaluation is generally necessary to accurately identify the lesion.

  8. Image-Guided Cryoablation of the Spine in a Swine Model: Clinical, Radiological, and Pathological Findings with Light and Electron Microscopy

    SciTech Connect

    Freitas, Ricardo Miguel Costa de Andrade, Celi Santos Caldas, José Guilherme Mendes Pereira; Tsunemi, Miriam Harumi; Ferreira, Lorraine Braga Arana-Chavez, Victor Elias; Cury, Patrícia Maluf

    2015-10-15

    PurposeThis study was designed to present the feasibility of an in vivo image-guided percutaneous cryoablation of the porcine vertebral body.MethodsThe institutional animal care committee approved this study. Cone-beam computed tomography (CBCT)-guided vertebral cryoablations (n = 22) were performed in eight pigs with short, 2-min, single or double-freezing protocols. Protective measures to nerves included dioxide carbon (CO{sub 2}) epidural injections and spinal canal temperature monitoring. Clinical, radiological, and pathological data with light (n = 20) or transmission electron (n = 2) microscopic analyses were evaluated after 6 days of clinical follow-up and euthanasia.ResultsCBCT/fluoroscopic-guided transpedicular vertebral body cryoprobe positioning and CO{sub 2} epidural injection were successful in all procedures. No major complications were observed in seven animals (87.5 %, n = 8). A minor complication was observed in one pig (12.5 %, n = 1). Logistic regression model analysis showed the cryoprobe-spinal canal (Cp-Sc) distance as the most efficient parameter to categorize spinal canal temperatures lower than 19 °C (p < 0.004), with a significant Pearson’s correlation test (p < 0.041) between the Cp-Sc distance and the lowest spinal canal temperatures. Ablation zones encompassed pedicles and the posterior wall of the vertebral bodies with an inflammatory rim, although no inflammatory infiltrate was depicted in the surrounding neural structures at light microscopy. Ultrastructural analyses evidenced myelin sheath disruption in some large nerve fibers, although neurological deficits were not observed.ConclusionsCBCT-guided vertebral cryoablation of the porcine spine is feasible under a combination of a short freezing protocol and protective measures to the surrounding nerves. Ultrastructural analyses may be helpful assess the early modifications of the nerve fibers.

  9. Basic bone radiology

    SciTech Connect

    Griffiths, H.J.

    1987-01-01

    This clinical book surveys the skeletal system as seen through radiological imaging. It emphasizing abnormalities, disease, and trauma, and includes vital information on bones, bone growth, and the cells involved in bone pathology. It covers many bone diseases and injuries which are rarely covered in medical texts, as well as descriptions of radiologic procedures that specifically relate to the skeleton. This edition includes many illustrations, information on MR imaging and CT scanning, and discussions of osteoporosis, dysplasias, and metabolic bone disease.

  10. Lipoprotein (a) measurements for clinical application.

    PubMed

    Marcovina, Santica M; Albers, John J

    2016-04-01

    The high degree of size heterogeneity of apo(a), the distinct protein component of lipoprotein (a) [Lp(a)], renders the development and selection of specific antibodies directed to apo(a) more difficult and poses significant challenges to the development of immunoassays to measure its concentration in plasma or serum samples. Apo(a) is extremely variable in size not only between but also within individuals because of the presence of two different, genetically determined apo(a) isoform sizes. Therefore, the antigenic determinants per particle available to interact with the antibodies will vary in the samples and the calibrators, thus contributing to apo(a) size-dependent inaccuracy of different methods. The lack of rigorous validation of the immunoassays and common means of expressing Lp(a) concentrations hinder the harmonization of results obtained by different studies and contribute to the lack of common cut points for identification of individuals at risk for coronary artery disease or for interventions aimed at reducing Lp(a) levels. The aim of our review is to present and critically evaluate the issues surrounding the measurements of Lp(a), their impact on the clinical interpretation of the data, and the obstacles we need to overcome to achieve the standardization of Lp(a) measurements. PMID:26637278

  11. Clinical applications of cortisol measurements in hair.

    PubMed

    Wester, Vincent L; van Rossum, Elisabeth F C

    2015-10-01

    Cortisol measurements in blood, saliva and urine are frequently used to examine the hypothalamus-pituitary-adrenal (HPA) axis in clinical practice and in research. However, cortisol levels are subject to variations due to acute stress, the diurnal rhythm and pulsatile secretion. Cortisol measurements in body fluids are not always a reflection of long-term cortisol exposure. The analysis of cortisol in scalp hair is a relatively novel method to measure cumulative cortisol exposure over months up to years. Over the past years, hair cortisol concentrations (HCC) have been examined in association with a large number of somatic and mental health conditions. HCC can be used to evaluate disturbances of the HPA axis, including Cushing's syndrome, and to evaluate hydrocortisone treatment. Using HCC, retrospective timelines of cortisol exposure can be created which can be of value in diagnosing cyclic hypercortisolism. HCC have also been shown to increase with psychological stressors, including major life events, as well as physical stressors, such as endurance exercise and shift work. Initial studies show that HCC may be increased in depression, but decreased in general anxiety disorder. In posttraumatic stress disorder, changes in HCC seem to be dependent on the type of traumatic experience and the time since traumatization. Increased hair cortisol is consistently linked to obesity, metabolic syndrome and cardiovascular disease. Potentially, HCC could form a future marker for cardiovascular risk stratification, as well as serve as a treatment target.

  12. Anti-tumor necrosis factor treatment in cherubism--clinical, radiological and histological findings in two children.

    PubMed

    Hero, M; Suomalainen, A; Hagström, J; Stoor, P; Kontio, R; Alapulli, H; Arte, S; Toiviainen-Salo, S; Lahdenne, P; Mäkitie, O

    2013-01-01

    Cherubism is a rare and disfiguring genetic disorder with excessive bone resorption and multilocular lesions in the mandible and/or maxilla. The disease-causing gain-of-function mutations in the SH3-binding protein 2 (SH3BP2) gene result in increased myeloid cell responses to macrophage colony stimulating factor and RANK ligand, formation of hyperactive osteoclasts (giant cells), and hyper-reactive macrophages that produce excessive amounts of the inflammatory cytokine tumor necrosis factor α (TNF-α). Recent findings in the cherubism mouse model suggest that TNF-α plays a major role in disease pathogenesis and that removal of TNF-α prevents development of the bone phenotype. We treated two children with cherubism with the TNF-α antagonist adalimumab for approximately 2.5 years and collected extensive clinical, radiological and histological follow-up data during the treatment. Histologically the treatment resulted in a significant reduction in the number of multinucleated giant cells and TNF-α staining positivity in both patients. As evaluated by computed tomography and magnetic resonance imaging, the lesions in Patient 1 showed either moderate enlargement (mandibular symphysis) or remained stable (mandibular rami and body, the maxilla). In Patient 2, the lesions in mandibular symphysis showed enlargement during the first 8 months of treatment, and thereafter the lesions remained unchanged. Bone formation and resorption markers remained unaffected. The treatment was well tolerated. Based on our findings, TNF-α antagonist may decrease the formation of pathogenic giant cells, but does not result in lesion regression or prevent lesion expansion in active cherubism. TNF-α modulator treatment thus does not appear to provide sufficient amelioration for patients suffering from cherubism. PMID:23069372

  13. Anti-tumor necrosis factor treatment in cherubism--clinical, radiological and histological findings in two children.

    PubMed

    Hero, M; Suomalainen, A; Hagström, J; Stoor, P; Kontio, R; Alapulli, H; Arte, S; Toiviainen-Salo, S; Lahdenne, P; Mäkitie, O

    2013-01-01

    Cherubism is a rare and disfiguring genetic disorder with excessive bone resorption and multilocular lesions in the mandible and/or maxilla. The disease-causing gain-of-function mutations in the SH3-binding protein 2 (SH3BP2) gene result in increased myeloid cell responses to macrophage colony stimulating factor and RANK ligand, formation of hyperactive osteoclasts (giant cells), and hyper-reactive macrophages that produce excessive amounts of the inflammatory cytokine tumor necrosis factor α (TNF-α). Recent findings in the cherubism mouse model suggest that TNF-α plays a major role in disease pathogenesis and that removal of TNF-α prevents development of the bone phenotype. We treated two children with cherubism with the TNF-α antagonist adalimumab for approximately 2.5 years and collected extensive clinical, radiological and histological follow-up data during the treatment. Histologically the treatment resulted in a significant reduction in the number of multinucleated giant cells and TNF-α staining positivity in both patients. As evaluated by computed tomography and magnetic resonance imaging, the lesions in Patient 1 showed either moderate enlargement (mandibular symphysis) or remained stable (mandibular rami and body, the maxilla). In Patient 2, the lesions in mandibular symphysis showed enlargement during the first 8 months of treatment, and thereafter the lesions remained unchanged. Bone formation and resorption markers remained unaffected. The treatment was well tolerated. Based on our findings, TNF-α antagonist may decrease the formation of pathogenic giant cells, but does not result in lesion regression or prevent lesion expansion in active cherubism. TNF-α modulator treatment thus does not appear to provide sufficient amelioration for patients suffering from cherubism.

  14. Anterior cervical fusion with a bio-resorbable composite cage (beta TCP-PLLA): clinical and radiological results from a prospective study on 20 patients.

    PubMed

    Debusscher, F; Aunoble, S; Alsawad, Y; Clement, D; Le Huec, Jean-Charles

    2009-09-01

    A resorbable composite material (40% PLLA and 60% beta TCP) with a high breaking strength and capacity to withstand plastic and elastic strain has been developed for cervical interbody fusion. This is a prospective study to evaluate clinical and radiological results of 20 patients implanted with 27 cages (mean follow-up, 27 months). Clinical (neck disability index, VAS, neurological evaluation) and radiological (anteroposterior, lateral, bending X-rays) data were assessed before and after surgery. At the end of the study, CT scan was performed to evaluate fusion, resorption of the cage and density of the new tissue substituting the cage. The mean patient age was 50.3 years (range, 18-79 years). The average improvement was 55% for neck pain, 83% for arm pain and 65% for NDI, with 85% good or excellent results at final outcomes. Radiologically, lordosis was significantly improved (mean gain of 5.4 degrees and 3.7 degrees for overall and segmental lordosis, respectively). This correction was conserved in 95% of cases. Fusion was obtained in 96% (CT evaluation). Resorption was started in all cases and completed in an average of 36 months after surgery. The mean density of tissue substituting the cage was 659 UH with a range, of 455-911 UH (compatible with bone nature). Over time, the amount of bony tissue increased and the graft remodelled with an increase in density value. This demonstrates a biological activity and changing bone mineral content of this tissue. The new composite cage under investigation provides long-term fusion without loss of correction or inflammatory reaction. The ceramic block guarantees the maintenance of the disc height and its slow resorption allows long-term fusion and stability with good and reliable clinical and radiological outcomes. PMID:19533180

  15. Anterior cervical fusion with a bio-resorbable composite cage (beta TCP–PLLA): clinical and radiological results from a prospective study on 20 patients

    PubMed Central

    Debusscher, F.; Aunoble, S.; Alsawad, Y.; Clement, D.

    2009-01-01

    A resorbable composite material (40% PLLA and 60% beta TCP) with a high breaking strength and capacity to withstand plastic and elastic strain has been developed for cervical interbody fusion. This is a prospective study to evaluate clinical and radiological results of 20 patients implanted with 27 cages (mean follow-up, 27 months). Clinical (neck disability index, VAS, neurological evaluation) and radiological (anteroposterior, lateral, bending X-rays) data were assessed before and after surgery. At the end of the study, CT scan was performed to evaluate fusion, resorption of the cage and density of the new tissue substituting the cage. The mean patient age was 50.3 years (range, 18–79 years). The average improvement was 55% for neck pain, 83% for arm pain and 65% for NDI, with 85% good or excellent results at final outcomes. Radiologically, lordosis was significantly improved (mean gain of 5.4° and 3.7° for overall and segmental lordosis, respectively). This correction was conserved in 95% of cases. Fusion was obtained in 96% (CT evaluation). Resorption was started in all cases and completed in an average of 36 months after surgery. The mean density of tissue substituting the cage was 659 UH with a range, of 455–911 UH (compatible with bone nature). Over time, the amount of bony tissue increased and the graft remodelled with an increase in density value. This demonstrates a biological activity and changing bone mineral content of this tissue. The new composite cage under investigation provides long-term fusion without loss of correction or inflammatory reaction. The ceramic block guarantees the maintenance of the disc height and its slow resorption allows long-term fusion and stability with good and reliable clinical and radiological outcomes. PMID:19533180

  16. Radiology practice models: the 2008 ACR Forum.

    PubMed

    Gunderman, Richard B; Weinreb, Jeffrey C; Van Moore, Arl; Hillman, Bruce J; Neiman, Harvey L; Thrall, James H

    2008-09-01

    The 2008 ACR Forum brought together a diverse group of participants from clinical radiology, radiology leadership and practice management, managed care, economics, law, and entrepreneurship in Washington, DC, in January 2008 to discuss current models of radiology practice and anticipate new ones. It addressed what forces shape the practice of radiology, how these forces are changing, and how radiology practices can most effectively respond to them in the future.

  17. Measurement of naturally occurring radionuclides in geothermal samples and assessment of radiological risks and radiation doses.

    PubMed

    Parmaksiz, A

    2013-12-01

    The analysis of (226)Ra, (232)Th and (40)K radionuclides has been carried out in geothermal water and residue samples collected from six wells of geothermal power plant and disposal site, using gamma-spectrometry system equipped with a high-purity germanium detector. The activity concentrations of nine geothermal water samples were found to be lower than minimum detectable activity (MDA) values. The activity concentration of the residue samples ranged from 40 ± 4 to 2694 ± 85 Bq kg(-1) for (226)Ra, 33 ± 4 to 2388 ± 85 Bq kg(-1) for (232)Th, and MDA value to 967 ± 30 Bq kg(-1) for (40)K. In the study, some radiological indexes were examined and found to be higher than the reference values for majority of the residue samples. The annual effective doses arising from some residue samples were calculated to be higher than the permitted dose rate for the public, i.e. 1 mSv y(-1).

  18. Investigation of an MLE Algorithm for Quantification of Aerial Radiological Measurements

    SciTech Connect

    Reed, Michael; Essex, James

    2012-05-10

    Aerial radiation detection is routinely used by many organizations (DHS, DOE, EPA, etc.) for the purposes of identifying the presence of and quantifying the existence of radiation along the ground. This work involves the search for lost or missing sources, as well as the characterization of large-scale releases such as might occur in a nuclear power plant accident. The standard in aerial radiological surveys involves flying large arrays of sodium-iodide detectors at altitude (15 to 700 meters) to acquire geo-referenced, 1 Hz, 1024-channel spectra. The historical shortfalls of this technology include: • Very low spatial resolution (typical field of view is circle of two-times altitude) • Relatively low detectability associated with large stand-off distances • Fundamental challenges in performing ground-level quantification This work uses modern computational power in conjunction with multi-dimensional deconvolution algorithms in an effort to improve spatial resolution, enhance detectability, and provide a robust framework for quantification.

  19. Radiology image perception and observer performance: How does expertise and clinical information alter interpretation? Stroke detection explored through eye-tracking

    NASA Astrophysics Data System (ADS)

    Cooper, Lindsey; Gale, Alastair; Darker, Iain; Toms, Andoni; Saada, Janak

    2009-02-01

    Historically, radiology research has been dominated by chest and breast screening. Few studies have examined complex interpretative tasks such as the reading of multidimensional brain CT or MRI scans. Additionally, no studies at the time of writing have explored the interpretation of stroke images; from novices through to experienced practitioners using eye movement analysis. Finally, there appears a lack of evidence on the clinical effects of radiology reports and their influence on image appraisal and clinical diagnosis. A computer-based, eye-tracking study was designed to assess diagnostic accuracy and interpretation in stroke CT and MR imagery. Eight predetermined clinical cases, five images per case, were presented to participants (novices, trainee, and radiologists; n=8). The presence or absence of abnormalities was rated on a five-point Likert scale and their locations reported. Half cases of the cases were accompanied by clinical information; half were not, to assess the impact of information on observer performance. Results highlight differences in visual search patterns amongst novice, trainee and expert observers; the most marked differences occurred between novice readers and experts. Experts spent more time in challenging areas of interest (AOI) than novices and trainee, and were more confident unless a lesion was large and obvious. The time to first AOI fixation differed by size, shape and clarity of lesion. 'Time to lesion' dropped significantly when recognition appeared to occur between slices. The influence of clinical information was minimal.

  20. IRQN award paper: Operational rounds: a practical administrative process to improve safety and clinical services in radiology.

    PubMed

    Donnelly, Lane F; Dickerson, Julie M; Lehkamp, Todd W; Gessner, Kevin E; Moskovitz, Jay; Hutchinson, Sally

    2008-11-01

    As part of a patient safety program in the authors' department of radiology, operational rounds have been instituted. This process consists of radiology leaders' visiting imaging divisions at the site of imaging and discussing frontline employees' concerns about patient safety, the quality of care, and patient and family satisfaction. Operational rounds are executed at a time to optimize the number of attendees. Minutes that describe the issues identified, persons responsible for improvement, and updated improvement plan status are available to employees online. Via this process, multiple patient safety and other issues have been identified and remedied. The authors believe that the process has improved patient safety, the quality of care, and the efficiency of operations. Since the inception of the safety program, the mean number of days between serious safety events involving radiology has doubled. The authors review the background around such walk rounds, describe their particular program, and give multiple illustrative examples of issues identified and improvement plans put in place.

  1. [Management of acute and subacute clinical situations by interventional radiology: non-vascular interventions and treatment for hemoptysis].

    PubMed

    Nemes, Balázs; Doros, Attila

    2015-04-26

    Interventional radiology provides fast, straightforward and tolerable solutions for many medical problems including acute and subacute situations. Aspiration and drainage of fluid collections, biliary and endourologic interventions and gastrointestinal interventions are parts of non-vascular interventions. In addition, the authors discuss in detail interventional radiological treatment options in patients with hemoptysis. In acute cases interventions must be performed within 12-24 hours. For background, an everyday 24 hours service should be provided with well-trained personnel, high quality equipment and devices, and a reasonable financial reimbursement should be included, too. Multidisciplinary teamwork, consultations, consensus in indications and structured education should make these centers function most effectively. PMID:26047152

  2. Primary hypertrophic osteoarthropathy caused by homozygous deletion in HPGD gene in a family: changing clinical and radiological findings with long-term follow-up.

    PubMed

    Tüysüz, Beyhan; Yılmaz, Saliha; Kasapçopur, Özgür; Erener-Ercan, Tuğba; Ceyhun, Emre; Bilguvar, Kaya; Günel, Murat

    2014-11-01

    Autosomal recessive primary hypertrophic osteoarthropathy1 (PHOAR1) is characterized by delayed closure of the fontanels, digital clubbing, arthropathy and periostosis. Homozygous mutations in hydroxyprostaglandin dehydrogenase (HPGD) gene are the underlying pathology of PHOAR1. The aim of this study was to analyze the HPGD gene and the changing clinical and radiological findings with advancing age of two siblings with the diagnosis of PHOAR1. A novel 2-bp homozygous deletion was found in exon 3 (c.310-311delCT) of HPGD gene in the patients. Clinical and radiological findings of the siblings were evaluated between 4 months and 8 years and 6 months of age. The painful swelling and sweating of the hands and feet, cranial ossification defect and expanded diaphyses were evident at infantile period and gradually showed improvement until 4 years of age. After the age of 4 years, digital clubbing and swelling of knees persisted, palmoplantar hyperkeratosis developed and acro-osteolysis became evident on hand radiographs. In conclusion, we suggest that the clinical findings of the patients with PHOAR1 should be classified in two periods as early and late childhood. We also observed that there was intrafamilial variability of clinical findings. PMID:24816859

  3. Radiomic Profiling of Glioblastoma: Identifying an Imaging Predictor of Patient Survival with Improved Performance over Established Clinical and Radiologic Risk Models.

    PubMed

    Kickingereder, Philipp; Burth, Sina; Wick, Antje; Götz, Michael; Eidel, Oliver; Schlemmer, Heinz-Peter; Maier-Hein, Klaus H; Wick, Wolfgang; Bendszus, Martin; Radbruch, Alexander; Bonekamp, David

    2016-09-01

    Purpose To evaluate whether radiomic feature-based magnetic resonance (MR) imaging signatures allow prediction of survival and stratification of patients with newly diagnosed glioblastoma with improved accuracy compared with that of established clinical and radiologic risk models. Materials and Methods Retrospective evaluation of data was approved by the local ethics committee and informed consent was waived. A total of 119 patients (allocated in a 2:1 ratio to a discovery [n = 79] or validation [n = 40] set) with newly diagnosed glioblastoma were subjected to radiomic feature extraction (12 190 features extracted, including first-order, volume, shape, and texture features) from the multiparametric (contrast material-enhanced T1-weighted and fluid-attenuated inversion-recovery imaging sequences) and multiregional (contrast-enhanced and unenhanced) tumor volumes. Radiomic features of patients in the discovery set were subjected to a supervised principal component (SPC) analysis to predict progression-free survival (PFS) and overall survival (OS) and were validated in the validation set. The performance of a Cox proportional hazards model with the SPC analysis predictor was assessed with C index and integrated Brier scores (IBS, lower scores indicating higher accuracy) and compared with Cox models based on clinical (age and Karnofsky performance score) and radiologic (Gaussian normalized relative cerebral blood volume and apparent diffusion coefficient) parameters. Results SPC analysis allowed stratification based on 11 features of patients in the discovery set into a low- or high-risk group for PFS (hazard ratio [HR], 2.43; P = .002) and OS (HR, 4.33; P < .001), and the results were validated successfully in the validation set for PFS (HR, 2.28; P = .032) and OS (HR, 3.45; P = .004). The performance of the SPC analysis (OS: IBS, 0.149; C index, 0.654; PFS: IBS, 0.138; C index, 0.611) was higher compared with that of the radiologic (OS: IBS, 0.175; C index, 0

  4. Clinical and radiological profile of ameloblastic fibro-odontoma: an update on an uncommon odontogenic tumor based on a critical analysis of 114 cases.

    PubMed

    Buchner, Amos; Kaffe, Israel; Vered, Marilena

    2013-03-01

    Ameloblastic fibro-odontoma is an uncommon benign tumor of the jaws that belongs to the group of mixed odontogenic tumors. The descriptions of its clinical and radiological features in the literature are not always accurate and sometimes even contradictory. The aim of the present study was to critically evaluate their clinical and radiological features as reported in the English-language literature. A total of 114 well-documented cases of ameloblastic fibro-odontomas (103 from publications and 11 of our own new cases) were analyzed. The patients' age ranged from 8 months to 26 years (mean 9.6). There were 74 (65 %) males, with a male-to-female ratio of 1.85:1 (P = 0.001). The mandible was involved in 74 (65 %) cases, and the mandible-to-maxilla ratio was 1.85:1 (P < 0.001). Nearly 80 % of the lesions were located in the posterior region of the jaws, and most (58 %) were in the posterior mandible. Radiographically, most of the lesions were unilocular and only a few (~10 %) were multilocular. Most lesions were mixed radiolucent-radiopaque, and only a few (~5 %) were radiolucent. Almost all lesions (~92 %) were associated with the crown of an unerupted tooth/teeth. This comprehensive analysis of a large number of patients with an uncommon lesion revealed that ameloblastic fibro-odontomas are significantly more common in males and in the mandible, and that multilocular lesions are uncommon. It also revealed that, based on their clinical and radiological features, some of them are probably true neoplasms while others appear to be developing odontomas (hamartomas).

  5. The Availability of Radiological Measurement of Femoral Anteversion Angle: Three-Dimensional Computed Tomography Reconstruction

    PubMed Central

    Byun, Ha Young; Shin, Heesuk; Lee, Eun Shin; Kong, Min Sik; Lee, Seung Hun

    2016-01-01

    Objective To assess the intra-rater and inter-rater reliability for measuring femoral anteversion angle (FAA) by a radiographic method using three-dimensional computed tomography reconstruction (3D-CT). Methods The study included 82 children who presented with intoeing gait. 3D-CT data taken between 2006 and 2014 were retrospectively reviewed. FAA was measured by 3D-CT. FAA is defined as the angle between the long axis of the femur neck and condylar axis of the distal femur. FAA measurement was performed twice at both lower extremities by each rater. The intra-rater and inter-rater reliability were calculated by intraclass correlation coefficient (ICC). Results One hundred and sixty-four lower limbs of 82 children (31 boys and 51 girls, 6.3±3.2 years old) were included. The ICCs of intra-rater measurement for the angle of femoral neck axis (NA) were 0.89 for rater A and 0.96 for rater B, and those of condylar axis (CA) were 0.99 for rater A and 0.99 for rater B, respectively. The ICC of inter-rater measurement for the angle of NA was 0.89 and that of CA was 0.92. By each rater, the ICCs of the intrarater measurement for FAA were 0.97 for rater A and 0.95 for rater B, respectively and the ICC of the inter-rater measurement for FAA was 0.89. Conclusion The 3D-CT measures for FAA are reliable within individual raters and between different raters. The 3D-CT measures of FAA can be a useful method for accurate diagnosis and follow-up of femoral anteversion. PMID:27152273

  6. A pilot study measuring changes in student impressions before and after clinical training using a questionnaire based on the semantic differential technique.

    PubMed

    Tamura, Naomi; Terashita, Takayoshi; Ogasawara, Katsuhiko

    2013-01-01

    Students with a positive impression of their studies can become more motivated. This study measured the learning impact of clinical training by comparing student impressions before and after clinical training. The study included 32 students of radiological technology in their final year with the Division of Radiological Science and Technology, Department of Health Sciences, School of Medicine, Hokkaido University. To measure student impressions of x-ray examination training, we developed a questionnaire using the semantic differential technique. The resulting factor analysis identified 2 factors that accounted for 44.9% of the 10 bipolar adjective scales. Factor 1 represented a "resistance" impression of x-ray examination training, and factor 2 represented a "responsibility" impression. The differences in factor scores before and after the clinical training suggest that student impressions are affected by clinical training. PMID:23920812

  7. Measuring student perceptions of clinical competence.

    PubMed

    Clark, Michele C; Owen, Steven V; Tholcken, Michele A

    2004-12-01

    In a large, southwestern, Gulf coast school of nursing, the faculty sought additional information to enhance their clinical evaluations of students. To gather such information, the faculty developed a rapid and psychometrically sound evaluation tool that elicited students' self-efficacy beliefs for newly learned clinical skills, and the perceived importance of the clinical skills they were mastering. The Self-Efficacy for Clinical Evaluation Scale (SECS) is a 30-item, dual-response scale that demonstrates strong psychometric properties. Scores on the SECS help faculty identify skills or content areas that students feel little confidence in using, even when students value those skills or content as very important. These insights are assisting course leaders in tailoring the course structure and teaching strategies to better meet students' educational and practice needs.

  8. Pituitary Stalk Interruption Syndrome from Infancy to Adulthood: Clinical, Hormonal, and Radiological Assessment According to the Initial Presentation

    PubMed Central

    Bar, Céline; Zadro, Charline; Diene, Gwenaelle; Oliver, Isabelle; Pienkowski, Catherine; Jouret, Béatrice; Cartault, Audrey; Ajaltouni, Zeina; Salles, Jean-Pierre; Sevely, Annick; Tauber, Maithé; Edouard, Thomas

    2015-01-01

    Background Patients with pituitary stalk interruption syndrome (PSIS) are initially referred for hypoglycemia during the neonatal period or growth retardation during childhood. PSIS is either isolated (nonsyndromic) or associated with extra-pituitary malformations (syndromic). Objective To compare baseline characteristics and long-term evolution in patients with PSIS according to the initial presentation. Study Design Sixty-seven patients with PSIS were included. Data from subgroups were compared: neonates (n = 10) versus growth retardation patients (n = 47), and syndromic (n = 32) versus nonsyndromic patients (n = 35). Results Neonates displayed a more severe hormonal and radiological phenotype than children referred for growth retardation, with a higher incidence of multiple hormonal deficiencies (100% versus 34%; P = 0.0005) and a nonvisible anterior pituitary lobe (33% versus 2%; P = 0.0017). Regular follow-up of growth might have allowed earlier diagnosis in the children with growth retardation, as decreased growth velocity and growth retardation were present respectively 3 and 2 years before referral. We documented a progressive worsening of endocrine impairment throughout childhood in these patients. Presence of extra-pituitary malformations (found in 48%) was not associated with more severe hormonal and radiological characteristics. Growth under GH treatment was similar in the patient groups and did not vary according to the pituitary MRI findings. Conclusions PSIS diagnosed in the neonatal period has a particularly severe hormonal and radiological phenotype. The progressive worsening of endocrine impairment throughout childhood justifies periodic follow-up to check for additional hormonal deficiencies. PMID:26562670

  9. Radiology of spinal curvature

    SciTech Connect

    De Smet, A.A.

    1985-01-01

    This book offers the only comprehensive, concise summary of both the clinical and radiologic features of thoracic and lumbar spine deformity. Emphasis is placed on idiopathic scoliosis, which represents 85% of all patients with scoliosis, but less common areas of secondary scoliosis, kyphosis and lordosis are also covered.

  10. Research Training in Radiology.

    ERIC Educational Resources Information Center

    National Inst. of General Medical Sciences (NIH), Bethesda, MD.

    Radiology today is a major clinical specialty of medicine in terms of the number and complexity of patient examinations, and the financial resources, physician manpower, and supporting personnel required for performing its functions. It reached its present status because it provides accurate methods of diagnosis for so many diseases. However, this…

  11. The use of a modular system to convert an anatomical total shoulder arthroplasty to a reverse shoulder arthroplasty: Clinical and radiological results.

    PubMed

    Weber-Spickschen, T S; Alfke, D; Agneskirchner, J D

    2015-12-01

    If a modular convertible total shoulder system is used as a primary implant for an anatomical total shoulder arthroplasty, failure of the prosthesis or the rotator cuff can be addressed by converting it to a reverse shoulder arthroplasty (RSA), with retention of the humeral stem and glenoid baseplate. This has the potential to reduce morbidity and improve the results. In a retrospective study of 14 patients (15 shoulders) with a mean age of 70 years (47 to 83) we reviewed the clinical and radiological outcome of converting an anatomical shoulder arthroplasty (ASA) to a RSA using a convertible prosthetic system (SMR system, Lima, San Daniele, Italy). The mean operating time was 64 minutes (45 to 75). All humeral stems and glenoid baseplates were found to be well-fixed and could be retained. There were no intra-operative or early post-operative complications and no post-operative infection. The mean follow-up was 43 months (21 to 83), by which time the mean visual analogue scale for pain had decreased from 8 pre-operatively to 1, the mean American Shoulder and Elbow Surgeons Score from 12 to 76, the mean Oxford shoulder score from 3 to 39, the mean Western Ontario Osteoarthritis of the Shoulder Score from 1618 to 418 and the mean Subjective shoulder value from 15 to 61. On radiological review, one patient had a lucency around the humeral stem, two had stress shielding. There were no fatigue fractures of the acromion but four cases of grade 1 scapular notching. The use of a convertible prosthetic system to revise a failed ASA reduces morbidity and minimises the rate of complications. The mid-term clinical and radiological results of this technique are promising.

  12. Cervical Arthroplasty for Moderate to Severe Disc Degeneration: Clinical and Radiological Assessments after a Minimum Follow-Up of 18 Months: Pfirrmann Grade and Cervical Arthroplasty

    PubMed Central

    Oh, Chang Hyun; Kim, Do Yeon; Ji, Gyu Yeul; Kim, Yeo Ju; Hyun, Dongkeun; Kim, Eun Young; Park, Hyeonseon; Park, Hyeong-Chun

    2014-01-01

    Purpose Clinical outcomes and radiologic results after cervical arthroplasty have been reported in many articles, yet relatively few studies after cervical arthroplasty have been conducted in severe degenerative cervical disc disease. Materials and Methods Sixty patients who underwent cervical arthroplasty (Mobi-C®) between April 2006 and November 2011 with a minimum follow-up of 18 months were enrolled in this study. Patients were divided into two groups according to Pfirrmann classification on preoperative cervical MR images: group A (Pfirrmann disc grade III, n=38) and group B (Pfirrmann disc grades IV or V, n=22). Visual analogue scale (VAS) scores of neck and arm pain, modified Oswestry Disability Index (mODI) score, and radiological results including cervical range of motion (ROM) were assessed before and after surgery. Results VAS and mean mODI scores decreased after surgery from 5.1 and 57.6 to 2.7 and 31.5 in group A and from 6.1 and 59.9 to 3.7 and 38.4 in group B, respectively. In both groups, VAS and mODI scores significantly improved postoperatively (p<0.001), although no significant intergroup differences were found. Also, cervical dynamic ROM was preserved or gradually improved up to 18 months after cervical arthroplasty in both groups. Global, segmental and adjacent ROM was similar for both groups during follow-up. No cases of device subsidence or extrusion were recorded. Conclusion Clinical and radiological results following cervical arthroplasty in patients with severe degenerative cervical disc disease were no different from those in patients with mild degenerative cervical disc disease after 18 months of follow-up. PMID:24954339

  13. [Radiological estimation of the protective measures used in agricultural complex of Belarus Republic in 2000-2005 (20 years after the accident on the Chernobyl NPP)].

    PubMed

    Podoliak, A G; Bogdevich, I M; Ageets, V Iu; Timofeev, S F

    2007-01-01

    The radiological estimation of the basic agrochemistry measures spent for the agriculture of the Republic of Belarus in 2000-2005 is given. Laws of behavior radionuclides 137Cs and 90Sr in agrosystems are considered depending on used protective a measures (countermeasures) and the primary goals on liquidation of consequences in sphere of agrarian and industrial complex which are necessary for solving during the remote period after accident ChNNP (in 2006-2010) are studied.

  14. Genetic variation in the Cytb gene of human cerebral Taenia solium cysticerci recovered from clinically and radiologically heterogeneous patients with neurocysticercosis

    PubMed Central

    Palafox-Fonseca, Héctor; Zúñiga, Gerardo; Bobes, Raúl José; Govezensky, Tzipe; Piñero, Daniel; Texco-Martínez, Laura; Fleury, Agnès; Proaño, Jefferson; Cárdenas, Graciela; Hernández, Marisela; Sciutto, Edda; Fragoso, Gladis

    2013-01-01

    Neurocysticercosis (NC) is a clinically and radiologically heterogeneous parasitic disease caused by the establishment of larval Taenia solium in the human central nervous system. Host and/or parasite variations may be related to this observed heterogeneity. Genetic differences between pig and human-derived T. solium cysticerci have been reported previously. In this study, 28 cysticerci were surgically removed from 12 human NC patients, the mitochondrial gene that encodes cytochrome b was amplified from the cysticerci and genetic variations that may be related to NC heterogeneity were characterised. Nine different haplotypes (Ht), which were clustered in four haplogroups (Hg), were identified. Hg 3 and 4 exhibited a tendency to associate with age and gender, respectively. However, no significant associations were found between NC heterogeneity and the different T. solium cysticerci Ht or Hg. Parasite variants obtained from patients with similar NC clinical or radiological features were genetically closer than those found in groups of patients with a different NC profile when using the Mantel test. Overall, this study establishes the presence of genetic differences in the Cytb gene of T. solium isolated from human cysticerci and suggests that parasite variation could contribute to NC heterogeneity. PMID:24271046

  15. Genetic variation in the Cytb gene of human cerebral Taenia solium cysticerci recovered from clinically and radiologically heterogeneous patients with neurocysticercosis.

    PubMed

    Palafox-Fonseca, Héctor; Zúñiga, Gerardo; Bobes, Raúl José; Govezensky, Tzipe; Piñero, Daniel; Texco-Martínez, Laura; Fleury, Agnès; Proaño, Jefferson; Cárdenas, Graciela; Hernández, Marisela; Sciutto, Edda; Fragoso, Gladis

    2013-11-01

    Neurocysticercosis (NC) is a clinically and radiologically heterogeneous parasitic disease caused by the establishment of larval Taenia solium in the human central nervous system. Host and/or parasite variations may be related to this observed heterogeneity. Genetic differences between pig and human-derived T. solium cysticerci have been reported previously. In this study, 28 cysticerci were surgically removed from 12 human NC patients, the mitochondrial gene that encodes cytochrome b was amplified from the cysticerci and genetic variations that may be related to NC heterogeneity were characterised. Nine different haplotypes (Ht), which were clustered in four haplogroups (Hg), were identified. Hg 3 and 4 exhibited a tendency to associate with age and gender, respectively. However, no significant associations were found between NC heterogeneity and the different T. solium cysticerci Ht or Hg. Parasite variants obtained from patients with similar NC clinical or radiological features were genetically closer than those found in groups of patients with a different NC profile when using the Mantel test. Overall, this study establishes the presence of genetic differences in the Cytb gene of T. solium isolated from human cysticerci and suggests that parasite variation could contribute to NC heterogeneity.

  16. Study of emergency room health care providers and the fixed facility physical capabilities to manage the presenting radiologically injured patient. Study report, July 1984-July 1985

    SciTech Connect

    Not Available

    1985-07-01

    This study examined emergency room health care providers to determine if their knowledge and clinical expertise is sufficient to appropriately manage radiologically injured patient. This study posed an unannounced disaster preparedness drill to measure the ability of the emergency room staff to care for radiologically injured patients. This study produced a checklist for measurement of the care. The clinical expertise and performance were satisfactory. The instrument for measuring the abilities of the clinical staff provided useful, but required some modification.

  17. Examining the Relationship between Clinical Decision Support and Performance Measurement

    PubMed Central

    Haggstrom, David A.; Saleem, Jason J.; Militello, Laura G.; Arbuckle, Nicole; Flanagan, Mindy; Doebbeling, Bradley N.

    2009-01-01

    In concept and practice, clinical decision support (CDS) and performance measurement represent distinct approaches to organizational change, yet these two organizational processes are interrelated. We set out to better understand how the relationship between the two is perceived, as well as how they jointly influence clinical practice. To understand the use of CDS at benchmark institutions, we conducted semistructured interviews with key managers, information technology personnel, and clinical leaders during a qualitative field study. Improved performance was frequently cited as a rationale for the use of clinical reminders. Pay-for-performance efforts also appeared to provide motivation for the use of clinical reminders. Shared performance measures were associated with shared clinical reminders. The close link between clinical reminders and performance measurement causes these tools to have many of the same implementation challenges. PMID:20351854

  18. Radiology of congenital heart disease

    SciTech Connect

    Amplatz, K.

    1986-01-01

    This is a text on the radiologic diagnosis of congenital heart disease and its clinical manifestations. The main thrust of the book is the logical approach which allows an understanding of the complex theory of congenital heart disease. The atlas gives a concise overview of the entire field of congenital heart disease. Emphasis is placed on the understanding of the pathophysiology and its clinical and radiological consequences. Surgical treatment is included since it provides a different viewpoint of the anatomy.

  19. Radiological investigations at the "Taiga" nuclear explosion site: Site description and in situ measurements.

    PubMed

    Ramzaev, V; Repin, V; Medvedev, A; Khramtsov, E; Timofeeva, M; Yakovlev, V

    2011-07-01

    In the summer of 2009, we performed a field survey of the "Taiga" peaceful underground nuclear explosion site, the Perm region, Russia (61.30° N, 56.60° E). The explosion was carried out by the USSR in 1971. This paper provides an extended summary of the available published data on the "Taiga" experiment. A detailed description of the site is illustrated by original aerial and ground-level photos. A large artificial lake (700 m long and 350 m wide) currently occupies the central area of the experimental site. The ground lip surrounding the lake is covered by a newly grown mixed forest. In situ measurements, performed in August 2009, revealed elevated levels of the γ-ray dose rate in air on the banks of the lake "Taiga". Two hot spots were detected on the eastern bank of the lake. The excess of the γ-ray radiation is attributable to the man-made radionuclides (60)Co and (137)Cs. The current external γ-ray dose rate to a human from the contaminations associated with the "Taiga" experiment was between 9 and 70 μSv per week. Periodic monitoring the site is recommended.

  20. Posterior spinal fusion for adolescent idiopathic thoracolumbar/lumbar scoliosis: clinical outcomes and predictive radiological factors for extension of fusion distal to caudal end vertebra.

    PubMed

    Roberts, S B; Tsirikos, A I; Subramanian, A S

    2014-08-01

    Clinical, radiological, and Scoliosis Research Society-22 questionnaire data were reviewed pre-operatively and two years post-operatively for patients with thoracolumbar/lumbar adolescent idiopathic scoliosis treated by posterior spinal fusion using a unilateral convex segmental pedicle screw technique. A total of 72 patients were included (67 female, 5 male; mean age at surgery 16.7 years (13 to 23)) and divided into groups: group 1 included 53 patients who underwent fusion between the vertebrae at the limit of the curve (proximal and distal end vertebrae); group 2 included 19 patients who underwent extension of the fusion distally beyond the caudal end vertebra. A mean scoliosis correction of 80% (45% to 100%) was achieved. The mean post-operative lowest instrumented vertebra angle, apical vertebra translation and trunk shift were less than in previous studies. A total of five pre-operative radiological parameters differed significantly between the groups and correlated with the extension of the fusion distally: the size of the thoracolumbar/lumbar curve, the lowest instrumented vertebra angle, apical vertebra translation, the Cobb angle on lumbar convex bending and the size of the compensatory thoracic curve. Regression analysis allowed an equation incorporating these parameters to be developed which had a positive predictive value of 81% in determining whether the lowest instrumented vertebra should be at the caudal end vertebra or one or two levels more distal. There were no differences in the Scoliosis Research Society-22 outcome scores between the two groups (p = 0.17). In conclusion, thoracolumbar/lumbar curves in patients with adolescent idiopathic scoliosis may be effectively treated by posterior spinal fusion using a unilateral segmental pedicle screw technique. Five radiological parameters correlate with the need for distal extension of the fusion, and an equation incorporating these parameters reliably informs selection of the lowest instrumented

  1. The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

    PubMed

    Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

    2014-12-01

    We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.

  2. How best to measure cough clinically.

    PubMed

    Birring, Surinder S; Spinou, Arietta

    2015-06-01

    It is possible to measure cough by assessing its severity, frequency, intensity, associated urge and its impact on quality of life. Cough severity can simply be assessed with a Visual Analogue Scale. Cough frequency can be assessed objectively with cough frequency monitors. Validated cough monitors include the Leicester Cough Monitor and the VitaloJAK. Cough reflex sensitivity measurement is better used to investigate the mechanisms of action of antitussive medications, rather than assessing efficacy. Health-Related Quality of Life measures are available to assess the impact of cough; they include the validated Leicester Cough Questionnaire and Cough-specific Quality of Life Questionnaire for adult patients. It is best to assess cough with a combination of subjective and objective tools, to capture its wide-ranging impact.

  3. Possible clinical outcome measures for clinical trials in patients with multiple sclerosis

    PubMed Central

    Goldman, Myla D.; Motl, Robert W.; Rudick, Richard A.

    2010-01-01

    Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease with both clinical and pathological heterogeneity. The complexity of the MS population has offered challenges to the measurement of MS disease progression in therapeutic trials. The current standard clinical outcome measures are relapse rate, Expanded Disability Severity Scale (EDSS), and the MS Functional Composite (MSFC). These measures each have strengths and some weakness. Two additional measures, the six-minute walk and accelerometry, show promise in augmenting current measures. MS therapeutics is a quickly advancing field which requires sensitive clinical outcome measures that can detect small changes in disability that reliably reflect long-term changes in sustained disease progression in a complex population. A single clinical outcome measure of sustained disease progression may remain elusive. Rather, an integration of current and new outcome measures may be most appropriate and utilization of different measures depending on the MS population and stage of the disease may be preferred. PMID:21179614

  4. JC Virus PCR Detection Is Not Infallible: A Fulminant Case of Progressive Multifocal Leukoencephalopathy with False-Negative Cerebrospinal Fluid Studies despite Progressive Clinical Course and Radiological Findings

    PubMed Central

    Babi, Mohamed-Ali; Pendlebury, William; Braff, Steven; Waheed, Waqar

    2015-01-01

    We describe a case with a false-negative PCR-based analysis for JC virus in cerebrospinal fluid (CSF) in a patient with clinical and radiological findings suggestive of progressive multifocal leukoencephalopathy (PML) who was on chronic immunosuppressive therapy for rheumatoid arthritis. Our patient developed rapidly progressive global decline with clinical and radiographic findings suggestive of PML, but JC virus PCR in CSF was negative. The patient passed away 3 months from the onset of her neurological symptoms. Autopsy confirmed the diagnosis of PML with presence of JC-polyoma virus by immunohistochemical staining. This case highlights the potential of false-negative JC virus PCR in CSF when radiographic and clinical features are suggestive of “possible PML.” We review the plausible causes of potential false-negative CSF results and suggest that when the clinical presentation is suspicious for PML repeat CSF analysis utilizing ultrasensitive PCR assay and subsequent brain biopsy should be considered if CSF remains negative. Additionally, appropriate exclusion of other neurologic conditions is essential. PMID:25861493

  5. Interventional radiology

    SciTech Connect

    Castaneda-Zuniga, W.R.

    1987-01-01

    This reference gives a step-by-step presentation of the elements of interventional radiology. CONTENTS: Introduction; Radiation protection; Embolotherapy; Interventional techniques in the management of gastrointestinal bleeding; Transluminal angioplasty; Thrombolytic therapy; Foreign body removal; Inferior vena cava filter placement; Percutaneous uroradiologic techniques; Interventional techniques in the biliary tract; Nonvascular gastrointestinal tract dilations; Percutaneous biopsy techniques; Drainage of abscess fluid collections in the abdomen.

  6. Orthopaedic radiology

    SciTech Connect

    Park, W.M.; Hughes, S.P.F.

    1985-01-01

    This book provides an account of the principles of modern diagnostic imaging techniques and their applications in orthopedics. The aim of the book is to show radiology as a dynamic subject which can help clinicians, while at the same time assisting radiologists to understand the needs of the orthopedic surgeon.

  7. Units of Measure in Clinical Information Systems

    PubMed Central

    Schadow, Gunther; McDonald, Clement J.; Suico, Jeffrey G.; Föhring, Ulrich; Tolxdorff, Thomas

    1999-01-01

    The authors surveyed existing standard codes for units of measures, such as ISO 2955, ANSI ×3.50, and Health Level 7′s ISO+. Because these standards specify only the character representation of units, the authors developed a semantic model for units based on dimensional analysis. Through this model, conversion between units and calculations with dimensioned quantities become as simple as calculating with numbers. All atomic symbols for prefixes and units are defined in one small table. Huge permutated conversion tables are not required. This method is also simple enough to be widely implementable in today's information systems. To promote the application of the method the authors provide an open-source implementation of this method in JAVA. All existing code standards for units, however, are incomplete for practical use and require substantial changes to correct their many ambiguities. The authors therefore developed a code for units that is much more complete and free from ambiguities. PMID:10094068

  8. Dysspondyloenchondromatosis (DSC) associated with COL2A1 mutation: Clinical and radiological overlap with spondyloepimetaphyseal dysplasia-Strudwick type (SEMD-S).

    PubMed

    Merrick, Blair; Calder, Alistair; Wakeling, Emma

    2015-12-01

    Dysspondyloenchondromatosis (DSC) is a rare skeletal dysplasia characterized by enchondroma-like lesions and anisospondyly. The former leads to discrepancies in limb length, and the latter, to progressive kyphoscoliosis. Two recent cases have highlighted the genetic heterogeneity of DSC, one demonstrating the presence and, the other, the absence of a COL2A1 mutation. This may have important clinical implications, for example, screening for complications including atlanto-axial instability associated with type II collagenopathies, as well as long-term patient management. We report on a case with radiographic features of DSC with overlap into the type II collagenopathy spondyloepimetaphyseal dysplasia, Strudwick type, who was found to carry a novel heterozygous mutation in the COL2A1 gene. Testing for COL2A1 mutations should be performed in all patients with radiological features of DSC. Further research is needed to identify the underlying molecular cause in cases where no COL2A1 mutation is identified.

  9. Can congenital pulmonary airway malformation be distinguished from Type I pleuropulmonary blastoma based on clinical and radiological features?☆,☆☆

    PubMed Central

    Feinberg, Adina; Hall, Nigel J.; Williams, Gretchen M.; Schultz, Kris Ann P.; Miniati, Doug; Hill, D. Ashley; Dehner, Louis P.; Messinger, Yoav H.; Langer, Jacob C.

    2016-01-01

    Background The management of congenital cystic lung lesions is controversial. Arguments for routine resection during infancy include the possibility of the lesion being Type I pleuropulmonary blastoma (PPB) rather than a cystic congenital pulmonary airway malformation (CPAM). We aimed to identify clinical and radiological features that might distinguish between CPAM and PPB and to develop a diagnostic algorithm based on these features. Methods All recorded cases of Type I PPB were retrieved from the International PPB Registry and compared with an institutional cohort of children undergoing resection of CPAM (2002–2013) that was noted at some stage to be at least partially cystic. Regression models were created to identify variables that might differentiate CPAM from PPB. Odds ratio (OR) and positive predictive value (PPV) were calculated for each variable and a decision algorithm developed. Results In 112 cases of Type I PPB and 103 of CPAM, factors favoring a diagnosis of CPAM included prenatal detection (OR 89.4), systemic feeding vessel (OR 61.7), asymptomatic (OR 8.0), and hyperinflated lung (OR 6.6). Factors favoring a diagnosis of PPB included bilateral or multisegment involvement (OR 2.4). A decision algorithm that helps to identify lesions requiring resection and those which can be safely observed is presented. Conclusion Clinical and radiological features can help to differentiate between CPAM and PPB. Our algorithm allows identification of children at higher risk of PPB in whom we would recommend resection and those at low risk in whom continued close observation is safe. PMID:26561249

  10. [Interventional radiology: current problems and new directions].

    PubMed

    Santos Martín, E; Crespo Vallejo, E

    2014-01-01

    In recent years, vascular and interventional radiology has become one of the fastest growing diagnostic and therapeutic specialties. This growth has been based on a fundamental concept: performing minimally invasive procedures under imaging guidance. This attractive combination has led to the interest of professionals from other clinical specialties outside radiology in performing this type of intervention. The future of vascular and interventional radiology, although uncertain, must be linked to clinical practice and multidisciplinary teamwork.

  11. Roadmap for harmonization of clinical laboratory measurement procedures.

    PubMed

    Greg Miller, W; Myers, Gary L; Lou Gantzer, Mary; Kahn, Stephen E; Schönbrunner, E Ralf; Thienpont, Linda M; Bunk, David M; Christenson, Robert H; Eckfeldt, John H; Lo, Stanley F; Nübling, C Micha; Sturgeon, Catharine M

    2011-08-01

    Results between different clinical laboratory measurement procedures (CLMP) should be equivalent, within clinically meaningful limits, to enable optimal use of clinical guidelines for disease diagnosis and patient management. When laboratory test results are neither standardized nor harmonized, a different numeric result may be obtained for the same clinical sample. Unfortunately, some guidelines are based on test results from a specific laboratory measurement procedure without consideration of the possibility or likelihood of differences between various procedures. When this happens, aggregation of data from different clinical research investigations and development of appropriate clinical practice guidelines will be flawed. A lack of recognition that results are neither standardized nor harmonized may lead to erroneous clinical, financial, regulatory, or technical decisions. Standardization of CLMPs has been accomplished for several measurands for which primary (pure substance) reference materials exist and/or reference measurement procedures (RMPs) have been developed. However, the harmonization of clinical laboratory procedures for measurands that do not have RMPs has been problematic owing to inadequate definition of the measurand, inadequate analytical specificity for the measurand, inadequate attention to the commutability of reference materials, and lack of a systematic approach for harmonization. To address these problems, an infrastructure must be developed to enable a systematic approach for identification and prioritization of measurands to be harmonized on the basis of clinical importance and technical feasibility, and for management of the technical implementation of a harmonization process for a specific measurand. PMID:21677092

  12. Reformulation of a clinical-dose system for carbon-ion radiotherapy treatment planning at the National Institute of Radiological Sciences, Japan.

    PubMed

    Inaniwa, Taku; Kanematsu, Nobuyuki; Matsufuji, Naruhiro; Kanai, Tatsuaki; Shirai, Toshiyuki; Noda, Koji; Tsuji, Hiroshi; Kamada, Tadashi; Tsujii, Hirohiko

    2015-04-21

    At the National Institute of Radiological Sciences (NIRS), more than 8,000 patients have been treated for various tumors with carbon-ion (C-ion) radiotherapy in the past 20 years based on a radiobiologically defined clinical-dose system. Through clinical experience, including extensive dose escalation studies, optimum dose-fractionation protocols have been established for respective tumors, which may be considered as the standards in C-ion radiotherapy. Although the therapeutic appropriateness of the clinical-dose system has been widely demonstrated by clinical results, the system incorporates several oversimplifications such as dose-independent relative biological effectiveness (RBE), empirical nuclear fragmentation model, and use of dose-averaged linear energy transfer to represent the spectrum of particles. We took the opportunity to update the clinical-dose system at the time we started clinical treatment with pencil beam scanning, a new beam delivery method, in 2011. The requirements for the updated system were to correct the oversimplifications made in the original system, while harmonizing with the original system to maintain the established dose-fractionation protocols. In the updated system, the radiation quality of the therapeutic C-ion beam was derived with Monte Carlo simulations, and its biological effectiveness was predicted with a theoretical model. We selected the most used C-ion beam with αr = 0.764 Gy(-1) and β = 0.0615 Gy(-2) as reference radiation for RBE. The C-equivalent biological dose distribution is designed to allow the prescribed survival of tumor cells of the human salivary gland (HSG) in entire spread-out Bragg peak (SOBP) region, with consideration to the dose dependence of the RBE. This C-equivalent biological dose distribution is scaled to a clinical dose distribution to harmonize with our clinical experiences with C-ion radiotherapy. Treatment plans were made with the original and the updated clinical-dose systems, and both

  13. Novel methods of measuring clinical outcomes from psoriasis and psoriatic arthritis clinical trials.

    PubMed

    Villacorta, Reginald; Hay, Joel W; Messali, Andrew

    2014-08-01

    Numerous instruments exist that measure the clinical and health related quality of life impact of psoriasis and psoriatic arthritis (PsA) in clinical trials. However, many of these instruments are not typically used in economic evaluations to inform decision problems facing health care decision makers. This study reviews the current state of psoriasis and PsA health outcome measures and evaluates their limitations in cost-effectiveness analyses (CEAs). We highlight the health related quality of life and clinical outcome measures that are typically used in CEAs, with special focus on studies with quality adjusted life years as a primary outcome measure. Despite the high prevalence of psoriasis and PsA health outcome measures in clinical trials, only a few are used in CEAs. The methods by which utilities are estimated from these measures vary across cost-effectiveness studies. These differences should be considered when conducting cost-effectiveness research in psoriasis and PsA.

  14. Clinical guidelines for responding to chemical, biological, radiological, nuclear and trauma/burn mass casualty incidents: Quick reference guides for emergency department staff.

    PubMed

    Albanese, Joseph; Burich, David; Smith, Deborah; Hayes, Lynn; Paturas, James; Tomassoni, Anthony

    The word 'DISASTER' may be used as a mnemonic for listing the critical elements of emergency response. The National Disaster Life Support Education Foundation's (NDLSEC) DISASTER paradigm emphasises out-of-hospital emergency response and includes the following elements: (1) detect; (2) incident command system; (3) security and safety; (4) assessment; (5) support; (6) triage and treatment; (7) evacuate; and (8) recovery. This paper describes how the DISASTER paradigm was used to create a series of clinical guidelines to assist the preparedness effort of hospitals for mitigating chemical, biological, radiological, nuclear incidents or explosive devices resulting in trauma/burn mass casualty incidents (MCIs) and their initial response to these events. Descriptive information was obtained from observations and records associated with this project. The information contributed by a group of subject matter experts in disaster medicine, at the Yale New Haven Health System Center for Emergency Preparedness and Disaster Response was used to author the clinical guidelines. Akin to the paradigm developed by the NDLSEC for conducting on-scene activities, the clinical guidelines use the letters in the word 'disaster' as a mnemonic for recalling the main elements required for mitigating MCIs in the hospital emergency department.

  15. Heterogeneous drug target expression as possible basis for different clinical and radiological response to the treatment of primary and metastatic renal cell carcinoma: suggestions from bench to bedside.

    PubMed

    Santoni, Matteo; Santini, Daniele; Massari, Francesco; Conti, Alessandro; Iacovelli, Roberto; Burattini, Luciano; Tortora, Giampaolo; Falconi, Massimo; Montironi, Rodolfo; Cascinu, Stefano

    2014-03-01

    Metastatic disease occurs in a significant percentage of patients with renal cell carcinoma (RCC) and is usually associated with an overall poor prognosis. However, not all of the sites of metastases seem to have the same prognostic significance in patients receiving targeted agents. Indeed, patients with lung-only metastases seem to present a better survival than patients with other sites, whereas liver and bone metastases are associated with a worst prognosis. Some clinical studies suggest that metastatic sites are more responsive than primary tumors. This event may be due to intratumor heterogeneity in terms of somatic mutations, chromosome aberrations, and tumor gene expression, primarily centered around Von Hippel-Lindau (VHL) pathway, such as VHL mutations, HIF levels, vascular endothelial growth factor (VEGF) isoforms, and VEGF receptor levels. Nevertheless, these data do not completely explain the discordant biological behavior between primary tumor and metastatic sites. Understanding the causes of this discordance will have profound consequences on translational research and clinical trials in RCC. In this review, we overview current data on the differences between primary RCC and metastases in terms of drug target expression and clinical/radiological response to targeted agents, thus describing the prognostic role of different metastatic sites in RCC patients.

  16. Dosimetry in diagnostic radiology.

    PubMed

    Meghzifene, Ahmed; Dance, David R; McLean, Donald; Kramer, Hans-Michael

    2010-10-01

    Dosimetry is an area of increasing importance in diagnostic radiology. There is a realisation amongst health professionals that the radiation dose received by patients from modern X-ray examinations and procedures can be at a level of significance for the induction of cancer across a population, and in some unfortunate instances, in the acute damage to particular body organs such as skin and eyes. The formulation and measurement procedures for diagnostic radiology dosimetry have recently been standardised through an international code of practice which describes the methodologies necessary to address the diverging imaging modalities used in diagnostic radiology. Common to all dosimetry methodologies is the measurement of the air kerma from the X-ray device under defined conditions. To ensure the accuracy of the dosimetric determination, such measurements need to be made with appropriate instrumentation that has a calibration that is traceable to a standards laboratory. Dosimetric methods are used in radiology departments for a variety of purposes including the determination of patient dose levels to allow examinations to be optimized and to assist in decisions on the justification of examination choices. Patient dosimetry is important for special cases such as for X-ray examinations of children and pregnant patients. It is also a key component of the quality control of X-ray equipment and procedures. PMID:20655679

  17. Measuring grade inflation: a clinical grade discrepancy score.

    PubMed

    Paskausky, Anna L; Simonelli, M Colleen

    2014-08-01

    Grade inflation presents pedagogical and safety concerns for nursing educators and is defined as a "greater percentage of excellent scores than student performances warrant" (Speer et al., 2000, p. 112). This descriptive correlational study evaluated the relationship of licensure exam-style final written exams and faculty assigned clinical grades from undergraduate students (N = 281) for evidence of grade inflation at a private undergraduate nursing program in the Northeast of the United States and developed a new measurement of grade inflation, the clinical grade discrepancy score. This measurement can be used in programs where clinical competency is graded on a numeric scale. Evidence suggested grade inflation was present and the clinical grade discrepancy score was an indicator of the severity of grade inflation. The correlation between licensure-style final written exams and faculty assigned clinical grades was moderate to low at 0.357. The clinical grade discrepancy scores were 98% positive indicating likely grade inflation. Some 70% of clinical grade discrepancy scores indicated a difference of student licensure-style final written exams and faculty assigned clinical grades of at least one full letter grade (10 points out of 100). Use of this new measure as a tool in exploring the prevalence of grade inflation and implications for patient safety are discussed. PMID:24602828

  18. Measuring grade inflation: a clinical grade discrepancy score.

    PubMed

    Paskausky, Anna L; Simonelli, M Colleen

    2014-08-01

    Grade inflation presents pedagogical and safety concerns for nursing educators and is defined as a "greater percentage of excellent scores than student performances warrant" (Speer et al., 2000, p. 112). This descriptive correlational study evaluated the relationship of licensure exam-style final written exams and faculty assigned clinical grades from undergraduate students (N = 281) for evidence of grade inflation at a private undergraduate nursing program in the Northeast of the United States and developed a new measurement of grade inflation, the clinical grade discrepancy score. This measurement can be used in programs where clinical competency is graded on a numeric scale. Evidence suggested grade inflation was present and the clinical grade discrepancy score was an indicator of the severity of grade inflation. The correlation between licensure-style final written exams and faculty assigned clinical grades was moderate to low at 0.357. The clinical grade discrepancy scores were 98% positive indicating likely grade inflation. Some 70% of clinical grade discrepancy scores indicated a difference of student licensure-style final written exams and faculty assigned clinical grades of at least one full letter grade (10 points out of 100). Use of this new measure as a tool in exploring the prevalence of grade inflation and implications for patient safety are discussed.

  19. Genitourinary radiology

    SciTech Connect

    McClennan, B.L.

    1982-01-01

    A literature review of genitourinary radiology highlights new findings in the field that have occurred in the past year. The physiology of contrast media, and the occasional life-threatening contrast medial reaction are discussed. Common urologic problems such as stones, infection, and obstruction are examined in order to interpret static radiographs in a more meaningful way. The field of interventional uroradiology continues to expand, with new procedures being tried and new indications for old procedures being developed. (KRM)

  20. Treatment of Femoral Neck Fracture with a Minimal Invasive Surgical Approach for Hemiarthroplasty – Clinical and Radiological Results in 180 Geriatric Patients

    PubMed Central

    Unger, A.C; Dirksen, B; Renken, F. G; Wilde, E; Willkomm, M; Schulz, A.P

    2014-01-01

    Purpose : The Direct Anterior Approach (DAA) is well established as a minimal access approach in elective orthopaedic hip surgery. For the growing number of elderly patients with femoral neck fractures treated with Bipolar Hip Hemiarthroplasty (BHH), only a few results do exist. The study shows the clinical and radiological outcome for 180 patients treated by a modified DAA with BHH. Materials and Methods : The data of 180 geriatric patients with medial femoral neck fractures were evaluated retrospectively. The general and surgical complications, mobilisation using the Timed Up and Go test (TUG), the social environment pre- and postoperative and the radiological results have been compared with established approaches for geriatric hip surgery. Results : After joint replacement, 18 (10%) patients were developed pneumonia, of which 3 (1.7%) died during hospitalisation. In 7 cases (4%), surgical revision had to be carried out: three times (1.7%) because of a seroma, three times (1.7%) because of subcutaneous infection, and one time (0.6%) because the BHH was removed, owing to deep wound infection. One dislocation (0.6%) occurred, as well as one femoral nerve lesion (0.6%) occured. 88.3% of patients were mobilised on walkers or crutches; the Timed Up and Go Test showed a significant improvement during inpatient rehabilitation. 83% were discharged to their usual social environment, 10% were transferred to a short-term care facility and 7% were relocated permanently to a nursing home. 3/4 of patients had a cemented stem alignment in the range between -5° and 5°, while 2/3 of patients had a maximum difference of 1 cm in leg length. Conclusion : Using the modified DAA, a high patient satisfaction is achieved after implantation of a BHH. The rate of major complications is just as low as in conventional approaches, and rapid mobilisation is possible. PMID:25136389

  1. Clinical and radiological evaluation of zinc oxide-eugenol and Maisto's paste as obturating materials in infected primary teeth--nine months study.

    PubMed

    Reddy, V V; Fernandes

    1996-06-01

    The present study, performed in-vivo, included 30 infected primary teeth in 26 children in the age group of 3-8 years. The purpose of this study was to compare the efficacy of two obturating materials, zinc oxide-eugenol and Maisto's paste, in infected primary teeth. 30 teeth were divided into two groups of 15 teeth. Teeth in Group I were obturated using zinc oxide-eugenol and those in Group II were obturated using Maisto's paste. On clinical evaluation, teeth obturated with Maisto's paste showed 100% success. Five teeth that were overfilled with Maisto's paste showed complete resorption of excess material within 3 months while the two teeth overfilled with zinc oxide-eugenol showed incomplete resorption of the excess material even after 9 months. Zinc oxide-eugenol treated cases showed only 26.7% bone regeneration while in case of Maisto's paste, it was 93%. Complete healing of the inter-radicular pathology was seen with Maisto's paste. However, the pathology was present in 40% of the zinc oxide-eugenol treated teeth even after 9 months. Maisto's paste was thus seen to be superior to zinc oxide-eugenol both in clinical as well as radiological evaluation, done over a period of 9 months in relation to bone regeneration, healing of inter-radicular pathology and resorption of excess material.

  2. Computed Tomography and Magnetic Resonance Enterography in Crohn's Disease: Assessment of Radiologic Criteria and Endpoints for Clinical Practice and Trials.

    PubMed

    Deepak, Parakkal; Fletcher, Joel G; Fidler, Jeff L; Bruining, David H

    2016-09-01

    Early recognition of Crohn's disease with initiation of disease-modifying therapy has emerged as a prominent inflammatory bowel disease management strategy. Clinical practice and trials have often focused on patient symptoms, and more recently, serologic tests, stool inflammatory markers, and/or endoscopic inflammatory features for study entry criteria, treatment targets, disease activity monitoring, and to assess therapeutic response. Unfortunately, patient symptoms do not correlate well with biological disease activity, and endoscopy potentially misses or underestimates disease extent and severity in small bowel Crohn's disease. Computed tomography enterography and magnetic resonance enterography (MRE) are potential tools to identify and quantify transmural structural damage and disease activity in the small bowel. In this review, we discuss the role of computed tomography enterography and MRE in disease management algorithms in clinical practice. We also compare the currently developed MRE-based scoring systems, their strengths and pitfalls, as well as the role for MRE in clinical trials for Crohn's disease. PMID:27508513

  3. Adult post-mortem imaging in traumatic and cardiorespiratory death and its relation to clinical radiological imaging

    PubMed Central

    Adlam, D; Robinson, C; Pakkal, M; Rutty, G N

    2014-01-01

    The use of post-mortem imaging is expanding throughout the world with increasing use of advanced imaging techniques, such as contrast-enhanced CT and MRI. The questions asked of post-mortem imaging are complex and can be very different, for example for natural sudden death investigation will focus on the cause, whereas for trauma the cause of death is often clear, but injury patterns may be very revealing in investigating the background to the incident. Post-mortem imaging is different to clinical imaging regarding both the appearance of pathology and the information required, but there is much to learn from many years of clinical research in the use of these techniques. Furthermore, it is possible that post-mortem imaging research could be used not only for investigating the cause of death but also as a model to conduct clinically relevant research. This article reviews challenges to the development of post-mortem imaging for trauma, identification and cardiorespiratory death, and how they may be influenced by current clinical thinking and practice. PMID:24338941

  4. Radiology Rounds

    PubMed Central

    1996-01-01

    The following represents the second part of the radiology cases which were presented in the June issue of JCCA. The radiographic findings and a brief discussion of the cases are provided for your interest. These cases were presented as part of a research study that dealt with radiographic interpretation by chiropractors. This research has been funded by the Chiropractic College of Radiologists (CCR). The Journal of the Canadian Chiropractic Association has also assisted in this project with the publication of these cases. It is our hope that everyone has enjoyed the case challenge, even if your were not selected as a participant in our study. ImagesCASE ICASE IICASE IIICASE IVCASE V

  5. Rapid-response impulsivity: definitions, measurement issues, and clinical implications.

    PubMed

    Hamilton, Kristen R; Littlefield, Andrew K; Anastasio, Noelle C; Cunningham, Kathryn A; Fink, Latham H L; Wing, Victoria C; Mathias, Charles W; Lane, Scott D; Schütz, Christian G; Swann, Alan C; Lejuez, C W; Clark, Luke; Moeller, F Gerard; Potenza, Marc N

    2015-04-01

    Impulsivity is a multifaceted construct that is a core feature of multiple psychiatric conditions and personality disorders. However, progress in understanding and treating impulsivity is limited by a lack of precision and consistency in its definition and assessment. Rapid-response impulsivity (RRI) represents a tendency toward immediate action that occurs with diminished forethought and is out of context with the present demands of the environment. Experts from the International Society for Research on Impulsivity (InSRI) met to discuss and evaluate RRI measures in terms of reliability, sensitivity, and validity, with the goal of helping researchers and clinicians make informed decisions about the use and interpretation of findings from RRI measures. Their recommendations are described in this article. Commonly used clinical and preclinical RRI tasks are described, and considerations are provided to guide task selection. Tasks measuring two conceptually and neurobiologically distinct types of RRI, "refraining from action initiation" (RAI) and "stopping an ongoing action" (SOA) are described. RAI and SOA tasks capture distinct aspects of RRI that may relate to distinct clinical outcomes. The InSRI group recommends that (a) selection of RRI measures should be informed by careful consideration of the strengths, limitations, and practical considerations of the available measures; (b) researchers use both RAI and SOA tasks in RRI studies to allow for direct comparison of RRI types and examination of their associations with clinically relevant measures; and (c) similar considerations be made for human and nonhuman studies in an effort to harmonize and integrate preclinical and clinical research.

  6. Single-blind randomized clinical trial to evaluate clinical and radiological outcomes after one year of immediate versus delayed implant placement supporting full-arch prostheses

    PubMed Central

    Pellicer-Chover, Hilario; Peñarrocha-Oltra, David; Bagán, Leticia; Fichy-Fernandez, Antonio J.; Canullo, Luigi

    2014-01-01

    Purpose: To evaluate and compare peri-implant health, marginal bone loss and success of immediate and delayed implant placement for rehabilitation with full-arch fixed prostheses. Material and Methods: The present study was a prospective, randomized, single-blind, clinical preliminary trial. Patients were randomized into two treatment groups. In Group A implants were placed immediately post-extraction and in Group B six months after extraction. The following control time-points were established: one week, six months and twelve months after loading. Measurements were taken of peri-implant crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis. Implant success rates were evaluated for the two groups. The study sample included fifteen patients (nine women and six men) with a mean average age of 63.7 years. One hundred and forty-four implants were placed: 76 placed in healed sites and 68 placed immediately. Results: At the moment of prosthetic loading, keratinized mucosa width and probing depth were higher in immediate implants than delayed implants, with statistically significant differences. However, after six and twelve months, differences between groups had disappeared. Bone loss was 0.54 ± 0.39 mm for immediate implants and 0.66 ± 0.25 mm for delayed implants (p=0.201). No implants failed in either group. Conclusions: The present study with a short follow-up and a small sample yielded no statistically significant differences in implant success and peri-implant marginal bone loss between immediate and delayed implants with fixed full-arch prostheses. Peri-implant health showed no statistically significant differences for any of the studied parameters (crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis) at the twelve-month follow-up. Key words:Immediate implants, delayed implants

  7. Real Time in Situ Gamma Radiation Measurements of the Plume Evolution from the Full-Scale Radiological Dispersal Device Field Trials.

    PubMed

    Korpach, Ed; Berg, Rodney; Erhardt, Lorne; Lebel, Luke; Liu, Chuanlei

    2016-05-01

    During the Full-Scale Radiological Dispersal Device Field Trials carried out in Suffield in 2012, several suites of detection and sampling equipment were used to measure and characterize the explosive dispersal of the short half-life radioactive tracer Lanthanum-140 ((140)La). The equipment deployed included networks of in situ real-time radiation monitoring detectors providing measurements of different sensitivities and characteristics. A dense array of lower sensitivity detectors was established near field, ranging from 10 to 450 m from the detonation location. A sparser array of more sensitive detectors was established in the far field (150 m to 3.5 km from the detonation location). Each was used to collect and report the dose rate data from the radioactive plume passage with a sample time resolution of 1 s. The two systems went through independent calibrations and were compared and shown to be consistent with each other. The in situ gamma radiation measurements have allowed the movement and evolution of the plume to be described and to identify deposition rates and non-uniformities in the temporal shape of the plume. This knowledge could be applied for emergency planning guidance for the case of release of radioactive material by a radiological dispersive device. PMID:27023030

  8. Tophus measurement as an outcome measure for clinical trials of chronic gout: progress and research priorities.

    PubMed

    Dalbeth, Nicola; McQueen, Fiona M; Singh, Jasvinder A; MacDonald, Patricia A; Edwards, N Lawrence; Schumacher, H Ralph; Simon, Lee S; Stamp, Lisa K; Neogi, Tuhina; Gaffo, Angelo L; Khanna, Puja P; Becker, Michael A; Taylor, William J

    2011-07-01

    Despite the recognition that tophus regression is an important outcome measure in clinical trials of chronic gout, there is no agreed upon method of tophus measurement. A number of methods have been used in clinical trials of chronic gout, from simple physical measurement techniques to more complex advanced imaging methods. This article summarizes methods of tophus measurement and discusses their properties. Physical measurement using Vernier calipers meets most aspects of the Outcome Measures in Rheumatology (OMERACT) filter. Rigorous testing of the complex methods, particularly with respect to reliability and sensitivity to change, is needed to determine the appropriate use of these methods. Further information is also required regarding which method of physical measurement is best for use in future clinical trials. The need to develop and test a patient-reported outcome measure of tophus burden is also highlighted.

  9. Choice Impulsivity: Definitions, Measurement Issues, and Clinical Implications

    PubMed Central

    Hamilton, Kristen R.; Mitchell, Marci R.; Wing, Victoria C.; Balodis, Iris M.; Bickel, Warren K.; Fillmore, Mark; Lane, Scott D.; Lejuez, C. W.; Littlefield, Andrew K.; Luijten, Maartje; Mathias, Charles W.; Mitchell, Suzanne H.; Napier, T. Celeste; Reynolds, Brady; Schütz, Christian G.; Setlow, Barry; Sher, Kenneth J.; Swann, Alan C.; Tedford, Stephanie E.; White, Melanie J.; Winstanley, Catharine A.; Yi, Richard; Potenza, Marc N.; Moeller, F. Gerard

    2015-01-01

    Background Impulsivity critically relates to many psychiatric disorders. Given the multi-faceted construct that impulsivity represents, defining core aspects of impulsivity is vital for the assessment and understanding of clinical conditions. Choice impulsivity (CI), involving the preferential selection of smaller sooner rewards over larger later rewards, represents one important type of impulsivity. Method The International Society for Research on Impulsivity (InSRI) convened to discuss the definition and assessment of CI and provide recommendations regarding measurement across species. Results Commonly used preclinical and clinical CI behavioral tasks are described, and considerations for each task are provided to guide CI task selection. Differences in assessment of CI (self-report, behavioral) and calculating CI indices (e.g., area-under-the-curve, indifference point, steepness of discounting curve) are discussed along with properties of specific behavioral tasks used in preclinical and clinical settings. Conclusions The InSRI group recommends inclusion of measures of CI in human studies examining impulsivity. Animal studies examining impulsivity should also include assessments of CI and these measures should be harmonized in accordance with human studies of the disorders being modeled in the preclinical investigations. The choice of specific CI measures to be included should be based on the goals of the study and existing preclinical and clinical literature using established CI measures. PMID:25867841

  10. Clinical Application Of The Direct Measurement Of Human Shape

    NASA Astrophysics Data System (ADS)

    Anderson, J.; Vincent, R.; Marks, P.; English, M. J.

    1980-07-01

    A system is described for the recording and measurement of human body shape by a series of circular ultrasound scans. Computer manipulation of the echo data provides a graphic display of body contour, and a measurement of total body surface area and volume. The theoretical resolution for distance measurements using this device is 2.5 mm, a figure achieved in practical calibration experiments using a metal test object. Measurements from the body surface, although less precise, are sufficiently accurate and reproducible to enable useful clinical information to be obtained, particularly in recording the morphological changes associated with obesity and malnutrition.

  11. Recurrent Intrathecal Methotrexate Induced Neurotoxicity in an Adolescent with Acute Lymphoblastic Leukemia: Serial Clinical and Radiologic Findings

    PubMed Central

    Brugnoletti, Fulvia; Morris, E. Brannon; Laningham, Fred H.; Patay, Zoltán; Pauley, Jennifer L; Pui, Ching-Hon; Jeha, Sima; Inaba, Hiroto

    2008-01-01

    Systemic and intrathecal methotrexate (MTX) are integral components of acute lymphoblastic leukemia (ALL) therapy, but can be associated with neurotoxicity. We describe here the case of an adolescent male with T-cell ALL who developed recurrent episodes of subacute neurotoxicity characterized by slurred speech, emotional lability, and hemiparesis after intrathecal MTX administration. Serial magnetic resonance imaging with diffusion-weighted imaging showed recurrent areas of restricted diffusion within cerebral hemispheric white matter, which correlated chronologically with the administration of intrathecal therapy and severity of clinical symptoms. Resolution of diffusion abnormalities did not preclude further toxicity and a large lesion could cause persisting symptoms. PMID:18831032

  12. Role Of The Bureau Of Radiological Health In Assessment Of Risks From Clinical Nuclear Magnetic Resonance (NMR) Procedures

    NASA Astrophysics Data System (ADS)

    Anderson, Mary P.; Athey, T. W.; Phillips, Robert A.

    1982-12-01

    The 1976 Medical Device Amendments to the Federal Food, Drug, and Cosmetic Act provide for the classification of a medical device intended for human use into one of three regulatory classes based on the extent of control necessary to ensure safety and effectiveness: Class I, General Controls; Class II, Performance Standards; Class III, Premarket Approval. Class III devices are those for which there is insufficient information available to ensure safety and effectiveness through General Controls and Performance Standards alone. New devices such as Nuclear Magnetic Resonance Imaging systems fall under Class III because they were developed after the date of the law's enactment (28 May 1976). Investigational studies involving human subjects undertaken to develop safety and effectiveness data for a post-enactment Class III device come under the Investigational Device Exemption (IDE) Regulation (21 CFR 812). This regulation distinguishes between investigations of devices that pose a significant risk to the human subject and those that do not. A significant risk investigation "presents a potential for serious risk to the health, safety, or welfare of a subject." Procedures for obtaining an IDE differ if the device does or does not pose a significant risk. The sponsor of a clinical trial, and ultimately the Institutional Review Board (IRB), have the primary responsibility to determine whether a certain clinical use of the investigational device represents a significant risk to the subject of the investigation. A finding of significant risk does not mean that a device is too hazardous for clinical studies, but it does mean that a formal application for an IDE must be made to and approved by the Food and Drug Administration (FDA) before a clinical trial can begin. If the device is deemed not to pose a significant risk, unless otherwise notified by FDA, the sponsor is not required to submit an IDE application to FDA. Instead, the sponsor and investigators must satisfy only

  13. Colloid osmotic pressure: its measurement and clinical value.

    PubMed Central

    Morissette, M. P.

    1977-01-01

    Plasma colloid osmotic pressure (COP) is an important determinant in the appearance of edema. The development of a simple technique for COP measurement, based on an electronic pressure transducer and a semipermeable membrane system, has led to an appreciation of the value of COP determinations in clinical practice. In a steady state the measured COP replicates the value computed from serum proteins. In pathologic sera a derived value is unreliable. The normal human plasma COP averages 25.4 mm Hg. This value tends to decrease with age, is lower in females and is also lower in subjects at bed rest. As a clinical tool COP measurement represents an unduplicated contribution to the differential diagnosis of pulmonary edema. In critically ill patients COP measurement represents a reliable predictor of survival. PMID:851930

  14. Rapid-Response Impulsivity: Definitions, Measurement Issues, and Clinical Implications

    PubMed Central

    Hamilton, Kristen R.; Littlefield, Andrew K.; Anastasio, Noelle C.; Cunningham, Kathryn A.; Fink, Latham H.; Wing, Victoria C.; Mathias, Charles W.; Lane, Scott D.; Schutz, Christian; Swann, Alan C.; Lejuez, C.W.; Clark, Luke; Moeller, F. Gerard; Potenza, Marc N.

    2015-01-01

    Impulsivity is a multi-faceted construct that is a core feature of multiple psychiatric conditions and personality disorders. However, progress in understanding and treating impulsivity in the context of these conditions is limited by a lack of precision and consistency in its definition and assessment. Rapid-response-impulsivity (RRI) represents a tendency toward immediate action that occurs with diminished forethought and is out of context with the present demands of the environment. Experts from the International Society for Research on Impulsivity (InSRI) met to discuss and evaluate RRI-measures in terms of reliability, sensitivity, and validity with the goal of helping researchers and clinicians make informed decisions about the use and interpretation of findings from RRI-measures. Their recommendations are described in this manuscript. Commonly-used clinical and preclinical RRI-tasks are described, and considerations are provided to guide task selection. Tasks measuring two conceptually and neurobiologically distinct types of RRI, “refraining from action initiation” (RAI) and “stopping an ongoing action” (SOA) are described. RAI and SOA-tasks capture distinct aspects of RRI that may relate to distinct clinical outcomes. The InSRI group recommends that: 1) selection of RRI-measures should be informed by careful consideration of the strengths, limitations, and practical considerations of the available measures; 2) researchers use both RAI and SOA tasks in RRI studies to allow for direct comparison of RRI types and examination of their associations with clinically relevant measures; and, 3) similar considerations should be made for human and non-human studies in an effort to harmonize and integrate pre-clinical and clinical research. PMID:25867840

  15. Choice of Approach Does Not Affect Clinical and Radiologic Outcomes: A Comparative Cohort of Patients Having Anterior Lumbar Interbody Fusion and Patients Having Lateral Lumbar Interbody Fusion at 24 Months

    PubMed Central

    Malham, Gregory M.; Parker, Rhiannon M.; Blecher, Carl M.; Chow, Fiona Y.; Seex, Kevin A.

    2015-01-01

    Study Design  Retrospective analysis of prospectively collected registry data. Objective  This study aimed to compare the clinical and radiologic outcomes between comparative cohorts of patients having anterior lumbar interbody fusion (ALIF) and patients having lateral lumbar interbody fusion (LLIF). Methods  Ninety consecutive patients were treated by a single surgeon with either ALIF (n = 50) or LLIF (n = 40). Inclusion criteria were patients age 45 to 70 years with degenerative disk disease or grade 1 to 2 spondylolisthesis and single-level pathology from L1 to S1. Patient-reported outcome measures included pain (visual analog scale), disability (Oswestry Disability Index [ODI]), and quality of life (Short Form 36 physical component score [PCS] and mental component scores [MCS]). Assessment of fusion and measurement of lordosis and posterior disk height were performed on computed tomography scans. Results  At 24 months, patients having ALIF had significant improvements in back (64%) and leg (65%) pain and ODI (60%), PCS (44%), and MCS (26%; p < 0.05) scores. Patients having LLIF had significant improvements in back (56%) and leg (57%) pain and ODI (52%), PCS (48%), and MCS (12%; p < 0.05) scores. Fourteen complications occurred in the ALIF group, and in the LLIF group, there were 17 complications (p > 0.05). The fusion rate was 100% for ALIF and 95% for LLIF (p = 0.1948). ALIF added ∼6 degrees of lordosis and 3 mm of height, primarily measured at L5–S1, and LLIF added ∼3 degrees of lordosis and 2 mm of height between L1 to L5. Mean follow-up was 34.1 months. Conclusions  In comparative cohorts of patients having ALIF and patients having LLIF at 24 months postoperatively, there were no significant differences in clinical outcomes, complication rates, or fusion rates. PMID:27433432

  16. Continuous measurement of intracranial pressure with SFT: clinical experiences.

    PubMed

    Yoneda, S; Matsuda, M; Handa, J; Handa, H

    1975-09-01

    In 29 consecutive patients, the epidural intracranial pressure (EDP) was continuously measured with a semiconductor strain film transducer, and with a telemetric monitoring system in two patients. Factors affecting the EDP during pre-, intra- and postoperative periods were analyzed and their significance in clinical practice stressed.

  17. Automated clinical data collection for national quality measurement reporting.

    PubMed

    Wang, Song; Noirot, Laura A; Reichley, Richard M; Storey, Patricia; Traynor, Patrick; Dunagan, Wm Claiborne; Bailey, Thomas C

    2007-01-01

    Collecting data for the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) ORYX Core Measurement Reporting can be automated using an object-oriented, client-developed program that extracts data from a clinical data repository and utilizes an MHA vendor upload process. The process eliminated 39% of the manual data collection efforts. PMID:18694244

  18. Measuring Depression in a Clinical Population Using the MMPI.

    ERIC Educational Resources Information Center

    Nelson, Linda D.

    1987-01-01

    Administered Minnesota Multiphasic Personality Inventory (MMPI) to clinically depressed and nondepressed inpatients, and compared scores from its Depression scale with scores from the Beck Depression Inventory. Demonstrated a positive linear relationship between the two measures and their ability to discriminate between depressed and nondepressed…

  19. Exploring Patient Activation in the Clinic: Measurement from Three Perspectives

    ERIC Educational Resources Information Center

    Ledford, Christy J. W.; Ledford, Christopher C.; Childress, Marc A.

    2013-01-01

    Objective. To further conceptualize and operationalize patient activation (PA), using measures from patient, physician, and researcher perspectives. Data Source/Study Setting. Multimethod observation in 2010 within a family medicine clinic. Study Design. Part of an intervention with 130 patients with type 2 diabetes, this observational study…

  20. Silicon Matrix Calcium Phosphate as a Bone Substitute: Early Clinical and Radiological Results in a Prospective Study With 12-Month Follow-up

    PubMed Central

    Pesántez, Carlos Fernando Arias; Oliveira, Leonardo

    2008-01-01

    Introduction Autograft has been the “gold standard” for orthopedic bone grafting applications, but with some clinical challenges. Here we present the rationale and clinical outcomes supporting the use of a bone substitute material that consists of a mixture of two calcium phosphates (HA and ß-TCP), which are integrated into a silicon xerogel matrix, promoting nanocrystalline apatite layers on the surface of the material following implantation into a physiological environment. Methods Twenty-four patients with a median age of 53.80 (36–81) years underwent lumbar spinal fusion for degenerative disease, selected by clinical presentation, X-rays, and MRI findings. Subjects were evaluated preoperatively and postoperatively at 1, 3, 6, and 12 months. The outcome assessment consisted of visual analog scale (VAS), Oswestry Disability Index (ODI), and radiological assessment analyzing the state of fusion on X-ray and CT evaluation by 3 independent radiologists. Results All patients completed 12-month follow-up. The mean VAS decreased from 9.3 (± 0.9) to 2.4 (± 1.6) and the mean ODI decreased from 55.0 (± 9.2) to 19.3 (± 11.4) at 12-month follow-up. Three months after surgery, 10 patients (41.67%) had solid fusion based on analysis of CT scans and dynamic radiographs. At 6 months postoperatively, the fusion rate had increased to 75% (18 patients). Twelve months after surgery, 95.83% of patients had solid fusion (23 patients). Conclusions The clinical results from this study of silicon matrix calcium phosphate are consistent with previous in vitro studies indicating that this material stimulates formation of a bioactive layer and provides an effective bone graft material for lumbar fusion applications. In comparison with previous studies involving rhBMP-2, silicon matrix calcium phosphate provided a lower fusion rate at 3- and 6-month follow-up points, but after 12 months, the fusion rate was similar, with no statistical differences and lower overall costs. No

  1. Cementless total hip replacement without femoral osteotomy in patients with severe developmental dysplasia of the hip: minimum 15-year clinical and radiological results.

    PubMed

    Imbuldeniya, A M; Walter, W L; Zicat, B A; Walter, W K

    2014-11-01

    We describe the clinical and radiological results of cementless primary total hip replacement (THR) in 25 patients (18 women and seven men; 30 THRs) with severe developmental dysplasia of the hip (DDH). Their mean age at surgery was 47 years (23 to 89). In all, 21 hips had Crowe type III dysplasia and nine had Crowe type IV. Cementless acetabular components with standard polyethylene liners were introduced as close to the level of the true acetabulum as possible. The modular cementless S-ROM femoral component was used with a low resection of the femoral neck. A total of 21 patients (25 THRs) were available for review at a mean follow-up of 18.7 years (15.8 to 21.8). The mean modified Harris hip score improved from 46 points pre-operatively to 90 at final follow up (p < 0.001). A total of 15 patients (17 THRs; 57%) underwent revision of the acetabular component at a mean of 14.6 years (7 to 20.8), all for osteolysis. Two patients (two THRs) had symptomatic loosening. No patient underwent femoral revision. Survival with revision of either component for any indication was 81% at 15 years (95% CI 60.1 to 92.3), with 21 patients at risk. This technique may reduce the need for femoral osteotomy in severe DDH, while providing a good long-term functional result. PMID:25371455

  2. Use of Clinical Decision Guidance as a New Public Health Tool for the Medical Management of Internal Contamination in Radiological Mass Casualty Scenarios.

    PubMed

    Wiley, Albert L

    2016-09-01

    This review is a discussion of special issues associated with the medical and public health management of persons at risk of internal contamination from radionuclides, following various radiological mass-casualty scenarios, as well as definition, discussion and use of the Clinical Decision Guidance (CDG) in such scenarios. Specific medical countermeasures are available for reducing the internal radiation dose and the subsequent stochastic and deterministic risks to persons internally contaminated with radionuclides from nuclear power plant, fuel processing and nuclear weapon accidents/incidents. There is a public health need for rapidly identifying and quantifying the 'source term' of such radiation exposures and assessment of the associated committed doses, so that appropriate medical countermeasure(s) can be given as soon as possible. The CDG, which was initially defined in NCRP-161, was specifically developed to be a new public health tool for facilitating the integration of local community healthcare professionals into the general medical, mass casualty, triage and treatment response of internally contaminated populations. PMID:27574325

  3. Clinical outcome study and radiological findings of Zweymuller metal on metal total hip arthroplasty. a follow-up of 6 to 15 years.

    PubMed

    Paleochorlidis, Ilias S; Badras, Leonidas S; Skretas, Efstathios F; Georgaklis, Vasilios A; Karachalios, Theofilos S; Malizos, Konstantinos N

    2009-01-01

    We report the clinical and radiological outcome of 99 Zweymuller metal on metal total hip arthroplasties in 84 patients followed up prospectively for a mean period of 9.5 (range, 6-15) years. There were 29 (34.5%) male and 55 (65.5%) female patients with a mean age of 62.85 years (range, 50-70 years) at the time of surgery. All patients had osteoarthritis. One acetabular component and one stem were revised due to aseptic loosening. One femoral stem was revised due to a periprosthetic fracture. HHS score improved from a preoperative mean of 62.56 points (SD 8.87) to a final postoperative follow-up mean of 93.48 (SD 7.7). Cumulative success rate for both implants at 13 years, with aseptic loosening as the end point, was 97.05%, while for both implants at 13 years, with revision for any reason as the end point, it was 91.17%. Satisfactory results were observed with the use of this prosthesis. PMID:20041375

  4. Clinical and radiological outcome of anterior–posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients

    PubMed Central

    Schwender, James D.; Safriel, Yair; Gilbert, Thomas J.; Mehbod, Amir A.; Denis, Francis; Transfeldt, Ensor E.; Wroblewski, Jill M.

    2009-01-01

    Abundant data are available for direct anterior/posterior spine fusion (APF) and some for transforaminal lumbar interbody fusion (TLIF), but only few studies from one institution compares the two techniques. One-hundred and thirty-three patients were retrospectively analyzed, 68 having APF and 65 having TLIF. All patients had symptomatic disc degeneration of the lumbar spine. Only those with one or two-level surgeries were included. Clinical chart and radiologic reviews were done, fusion solidity assessed, and functional outcomes determined by pre- and postoperative SF-36 and postoperative Oswestry Disability Index (ODI), and a satisfaction questionnaire. The minimum follow-up was 24 months. The mean operating room time and hospital length of stay were less in the TLIF group. The blood loss was slightly less in the TLIF group (409 vs. 480 cc.). Intra-operative complications were higher in the APF group, mostly due to vein lacerations in the anterior retroperitoneal approach. Postoperative complications were higher in the TLIF group due to graft material extruding against the nerve root or wound drainage. The pseudarthrosis rate was statistically equal (APF 17.6% and TLIF 23.1%) and was higher than most published reports. Significant improvements were noted in both groups for the SF-36 questionnaires. The mean ODI scores at follow-up were 33.5 for the APF and 39.5 for the TLIF group. The patient satisfaction rate was equal for the two groups. PMID:19125304

  5. Clinical and radiological features of imported chikungunya fever in Japan: a study of six cases at the National Center for Global Health and Medicine.

    PubMed

    Mizuno, Yasutaka; Kato, Yasuyuki; Takeshita, Nozomi; Ujiie, Mugen; Kobayashi, Taiichiro; Kanagawa, Shuzo; Kudo, Koichiro; Lim, Chang-Kweng; Takasaki, Tomohiko

    2011-06-01

    Chikungunya fever (CHIKF) is currently distributed in Africa and in South and Southeast Asia; outbreaks have occurred periodically in the region over the past 50 years. After a large outbreak had occurred in countries in the western Indian Ocean region in 2005, several countries reported cases of CHIKF from travelers who had visited affected areas. In Japan, there have been only 15 cases of CHIKF patients so far, according to the National Institute of Infectious Diseases. Therefore, to evaluate the clinical and radiological features associated with the disease, we describe 6 imported cases of CHIKF. All of the patients had had prolonged arthralgia on admission to our hospital, and diagnosis was confirmed with specific antibodies by using an IgM-capture enzyme-linked immunoassay and a plaque reduction neutralizing antibody assay. Magnetic resonance imaging (MRI) of one patient revealed erosive arthritis and tenosynovitis during the convalescence stage. Clinicians should be aware of the late consequences of infection by the chikungunya virus (CHIKV) and recognize the possible association of subacute and chronic arthritis features. In addition, competent vectors of CHIKV, Aedes aegypti, can now be found in many temperate areas of the eastern and western hemispheres, including Japan. This fact raises concern that the virus could be introduced and become established in these areas. This necessitates an increased awareness of the disease, because imported cases are likely to contribute to the spread of CHIKV infection wherever the competent mosquito vectors are distributed.

  6. Asymptomatic pulmonary embolism in lung cancer: prevalence and analysis of clinical and radiological characteristics in 141 outpatients.

    PubMed

    Tiseo, Marcello; Bersanelli, Melissa; Pesenti Barili, Matteo; Bartolotti, Marco; De Luca, Giovanni; Gelsomino, Francesco; Camisa, Roberta; Cademartiri, Filippo; Ardizzoni, Andrea

    2012-01-01

    Aims and background. The incidence of asymptomatic pulmonary embolism in cancer patients is unknown and strictly related to the imaging used for tumor assessment. Recent findings suggest a similar clinical outcome of asymptomatic pulmonary embolism events compared to symptomatic events with a significant impact on survival. The aim of the present study was to determine the prevalence of asymptomatic pulmonary embolism in a population of lung cancer outpatients and to investigate its clinical features. Methods. Outpatients with a diagnosis of lung carcinoma undergoing chemotherapy were selected from October 2006 to June 2009. Disease and patient characteristics, risk factors and treatment modalities were collected. All the computed tomography images performed for each patient during the study period were retrospectively reviewed to identify pulmonary embolism. Results. A total of 141 consecutive patients were included and 657 computed tomography scans were completely reviewed (from two to six consecutive scans for each patient). Asymptomatic pulmonary embolism in the study population had a prevalence of 14.9% (21 patients). Most of the events occurred in patients with adenocarcinoma, advanced stage and poor performance status, during the early phases of first-line chemotherapy or at the same time of the cancer diagnosis. Compared with the symptomatic pulmonary embolism events (5 patients), asymptomatic events occurred earlier (time from cancer diagnosis to pulmonary embolism of 3.5 [95% CI, 2.0-4.9] versus 12.1 months [95% CI, 6.3-17.9; P = 0.02]) and had a better prognosis (survival from PE of 7.5 [95% CI, 3.4-11.6] versus 1.9 months [95% CI, 0-3.9; P = 0.04]). Conclusions. Our findings indicate an underestimation of embolic events among lung cancer outpatients due to their frequent asymptomatic natur. Such a high prevalence suggests the importance to pay more attention to pulmonary embolism prevention in this population. PMID:23235754

  7. Laminoplasty versus laminectomy and fusion for multilevel cervical myelopathy: a meta-analysis of clinical and radiological outcomes.

    PubMed

    Lee, Chang-Hyun; Lee, Jaebong; Kang, James D; Hyun, Seung-Jae; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib

    2015-06-01

    OBJECT Posterior cervical surgery, expansive laminoplasty (EL) or laminectomy followed by fusion (LF), is usually performed in patients with multilevel (≥ 3) cervical spondylotic myelopathy (CSM). However, the superiority of either of these techniques is still open to debate. The aim of this study was to compare clinical outcomes and postoperative kyphosis in patients undergoing EL versus LF by performing a meta-analysis. METHODS Included in the meta-analysis were all studies of EL versus LF in adults with multilevel CSM in MEDLINE (PubMed), EMBASE, and the Cochrane library. A random-effects model was applied to pool data using the mean difference (MD) for continuous outcomes, such as the Japanese Orthopaedic Association (JOA) grade, the cervical curvature index (CCI), and the visual analog scale (VAS) score for neck pain. RESULTS Seven studies comprising 302 and 290 patients treated with EL and LF, respectively, were included in the final analyses. Both treatment groups showed slight cervical lordosis and moderate neck pain in the baseline state. Both groups were similarly improved in JOA grade (MD 0.09, 95% CI -0.37 to 0.54, p = 0.07) and neck pain VAS score (MD -0.33, 95% CI -1.50 to 0.84, p = 0.58). Both groups evenly lost cervical lordosis. In the LF group lordosis seemed to be preserved in long-term follow-up studies, although the difference between the 2 treatment groups was not statistically significant. CONCLUSIONS Both EL and LF lead to clinical improvement and loss of lordosis evenly. There is no evidence to support EL over LF in the treatment of multilevel CSM. Any superiority between EL and LF remains in question, although the LF group shows favorable long-term results.

  8. Open reduction and internal fixation of extracapsular mandibular condyle fractures: a long-term clinical and radiological follow-up of 25 patients

    PubMed Central

    2014-01-01

    Background During the last 2 decades, many studies on the treatment of mandibular condyle fracture have been published. The incidence of mandibular condyle fractures is variable, ranging from 17.5% to 52% of all mandibular fractures. This retrospective study evaluated the long-term clinical and radiological outcomes after surgical treatment of 25 patients with a total of 26 extracapsular condyle fractures. Methods We used 2 types of surgical approaches, the retromandibular retroparotid or preauricular approach. Three kinds of rigid internal fixation plates were used—single plate, double plate, and trapezoidal plate. The following post-operative clinical parameters were evaluated: dental occlusion, facial nerve functionality, skin scarring, and temporomandibular joint functionality. All patients underwent post-operative orthopanoramic radiography and computed tomography. The patients were also monitored for complications such as Frey’s syndrome, infection, salivary fistula, plate fracture, and permanent paralysis of the facial nerve; the patient’s satisfaction was also recorded. Results Of the 25 patients, 80% showed occlusion recovery, 88% had no facial nerve injury, and 88% presented good surgical skin scarring. The patients showed early complete recovery of temporomandibular joint functionality and 72% of them were found to be asymptomatic. The postoperative radiographs of all patients indicated good recovery of the anatomical condylar region, and 80% of them had no postoperative complications. The average degree of patient satisfaction was 8.32 out of 10. Our results confirm that the technique of open reduction and internal fixation in association with postoperative functional rehabilitation therapy should be considered for treating patients with extracapsular condylar fractures. Conclusion The topic of condylar injury has generated more discussion and controversy than any other topic in the field of maxillofacial trauma. We confirm that open reduction and

  9. The Prevalence of Tonsilloliths and Other Soft Tissue Calcifications in Patients Attending Oral and Maxillofacial Radiology Clinic of the University of Iowa

    PubMed Central

    Bamgbose, Babatunde Olamide; Ruprecht, Axel; Timmons, Sherry; Qian, Fang

    2014-01-01

    Objective. The purpose of this study was to determine the prevalence of tonsiliths in patients attending the oral and maxillofacial radiology clinic of The University of Iowa and to determine if there is any correlation between the presence of tonsiliths and the presence of stones in other body tissues, ducts, or organs. Study Design. This was a two-part study. The first part was a prevalence study whereas the second was a matched pair case-control study. The matched pair case-control study commenced after the prevalence study was concluded. No new or unusual radiographs were made in this study. The study only reviewed radiographs that were made for clinical purposes. Results. A total of 1524 pantomographs were reviewed and 124 subjects (53 males and 71 females) aged 9 years and 2 months to 87 years (mean age 52.6 years) were included for data analysis. Thirty-eight subjects had single tonsiliths whereas 86 subjects had multiple tonsiliths. The prevalence of tonsiliths in the study population was 8.14%. A total of 20 subjects were included in the second part of the study, comprising 10 each for matched pair case-control groups. The observations did not indicate any correlation between the presence of tonsiliths and the presence of stones in other body tissues, ducts, or organs. Conclusion. The prevalence of tonsiliths in our study population was 8.14%. The observations in our study do not support any correlations between tonsiliths and calcifications in other body tissues, organs, or ducts. PMID:24587913

  10. Outcome measures for clinical drug trials in autism.

    PubMed

    Aman, Michael G; Novotny, Sherie; Samango-Sprouse, Carole; Lecavalier, Luc; Leonard, Elizabeth; Gadow, Kenneth D; King, Bryan H; Pearson, Deborah A; Gernsbacher, Morton Ann; Chez, Michael

    2004-01-01

    This paper identifies instruments and measures that may be appropriate for randomized clinical trials in participants with autism spectrum disorders (ASDs). The Clinical Global Impressions scale was recommended for all randomized clinical trials. At this point, however, there is no "perfect" choice of outcome measure for core features of autism, although we will discuss five measures of potential utility. Several communication instruments are recommended, based in part on suitability across the age range. In trials where the intention is to alter core features of ASDs, adaptive behavior scales are also worthy of consideration. Several "behavior complexes" common to ASDs are identified, and instruments are recommended for assessment of these. Given the prevalence of cognitive impairment in ASDs, it is important to assess any cognitive effects, although cognitive data from ASD randomized clinical trials, thus far, are minimal. Guidance from trials in related pharmacologic areas and behavioral pharmacology may be helpful. We recommend routine elicitation of side effects, height and weight, vital signs, and (in the case of antipsychotics) extrapyramidal side-effects assessment. It is often appropriate to include laboratory tests and assessments for continence and sleep pattern.

  11. Rapid-response impulsivity: definitions, measurement issues, and clinical implications.

    PubMed

    Hamilton, Kristen R; Littlefield, Andrew K; Anastasio, Noelle C; Cunningham, Kathryn A; Fink, Latham H L; Wing, Victoria C; Mathias, Charles W; Lane, Scott D; Schütz, Christian G; Swann, Alan C; Lejuez, C W; Clark, Luke; Moeller, F Gerard; Potenza, Marc N

    2015-04-01

    Impulsivity is a multifaceted construct that is a core feature of multiple psychiatric conditions and personality disorders. However, progress in understanding and treating impulsivity is limited by a lack of precision and consistency in its definition and assessment. Rapid-response impulsivity (RRI) represents a tendency toward immediate action that occurs with diminished forethought and is out of context with the present demands of the environment. Experts from the International Society for Research on Impulsivity (InSRI) met to discuss and evaluate RRI measures in terms of reliability, sensitivity, and validity, with the goal of helping researchers and clinicians make informed decisions about the use and interpretation of findings from RRI measures. Their recommendations are described in this article. Commonly used clinical and preclinical RRI tasks are described, and considerations are provided to guide task selection. Tasks measuring two conceptually and neurobiologically distinct types of RRI, "refraining from action initiation" (RAI) and "stopping an ongoing action" (SOA) are described. RAI and SOA tasks capture distinct aspects of RRI that may relate to distinct clinical outcomes. The InSRI group recommends that (a) selection of RRI measures should be informed by careful consideration of the strengths, limitations, and practical considerations of the available measures; (b) researchers use both RAI and SOA tasks in RRI studies to allow for direct comparison of RRI types and examination of their associations with clinically relevant measures; and (c) similar considerations be made for human and nonhuman studies in an effort to harmonize and integrate preclinical and clinical research. PMID:25867840

  12. Application of nitric oxide measurements in clinical conditions beyond asthma

    PubMed Central

    Malinovschi, Andrei; Ludviksdottir, Dora; Tufvesson, Ellen; Rolla, Giovanni; Bjermer, Leif; Alving, Kjell; Diamant, Zuzana

    2015-01-01

    Fractional exhaled nitric oxide (FeNO) is a convenient, non-invasive method for the assessment of active, mainly Th2-driven, airway inflammation, which is sensitive to treatment with standard anti-inflammatory therapy. Consequently, FeNO serves as a valued tool to aid diagnosis and monitoring in several asthma phenotypes. More recently, FeNO has been evaluated in several other respiratory, infectious, and/or immunological conditions. In this short review, we provide an overview of several clinical studies and discuss the status of potential applications of NO measurements in clinical conditions beyond asthma. PMID:26672962

  13. Women with TSC: Relationship between Clinical, Lung Function and Radiological Features in a Genotyped Population Investigated for Lymphangioleiomyomatosis

    PubMed Central

    Imeri, Gianluca; Palumbo, Giuseppina; La Briola, Francesca; Tresoldi, Silvia; Volpi, Angela; Gualandri, Lorenzo; Ghelma, Filippo; Alfano, Rosa Maria; Montanari, Emanuele; Gorio, Alfredo; Lesma, Elena; Peron, Angela; Canevini, Maria Paola; Centanni, Stefano

    2016-01-01

    The advent of pharmacological therapies for lymphangioleiomyomatosis (LAM) has made early diagnosis important in women with tuberous sclerosis complex (TSC), although the lifelong cumulative radiation exposure caused by chest computer tomography (CT) should not be underestimated. We retrospectively investigated, in a cohort of TSC outpatients of San Paolo Hospital (Milan, Italy) 1) the role of pulmonary function tests (PFTs) for LAM diagnosis, 2) the association between LAM and other features of TSC (e.g. demography, extrapulmonary manifestations, genetic mutations, etc.), and 3) the characteristics of patients with multifocal micronodular pneumocyte hyperplasia (MMPH). Eighty-six women underwent chest CT scan; pulmonary involvement was found in 66 patients (77%; 49% LAM with or without MMPH, and 28% MMPH alone). LAM patients were older, with a higher rate of pneumothorax, presented more frequently with renal and hepatic angiomyolipomas, and tended to have a TSC2 mutation profile. PFTs, assessed in 64% of women unaffected by cognitive impairments, revealed a lower lung diffusion capacity in LAM patients. In multivariate analysis, age, but not PFTs, resulted independently associated with LAM diagnosis. Patients with MMPH alone did not show specific clinical, functional or genetic features. A mild respiratory impairment was most common in LAM-TSC patients: In conclusions, PFTs, even if indicated to assess impairment in lung function, are feasible in a limited number of patients, and are not significantly useful for LAM diagnosis in women with TSC. PMID:27171001

  14. Image processing for the rest of us: the potential utility of inexpensive computerized image analysis in clinical pathology and radiology.

    PubMed

    McEachron, D L; Hess, S; Knecht, L B; True, L D

    1989-01-01

    Recent progress in computer technology in both hardware and software, combined with marked cost reductions, have placed quantitatively accurate video densitometry systems within the reach of the individual clinician, biomedical researcher, and community hospital. While much of the attention generated by advances in image processing has focussed on larger scale procedures, such as CAT, chemical shift, and positron emission tomography, important applications can be found for considerably more modest systems. In this article, we discuss three such applications of DUMAS, a personal computer-based imaging system developed by the Image Processing Center at Drexel University. A potential technique for quantifying numbers of estrogen receptors in tumorous breast tissue samples as a predictor of patient responsiveness to hormonal therapy is described first, along with possible sources of error. The second application, also related to clinical pathology and cancer, outlines methods for relating changes in nuclear and cell morphology to the diagnosis of Sezary Cell Syndrome. The utility of binary image filtering methods in the classification of cell types is discussed. The third application involves the development of a semi-automatic procedure for the determination of vessel diameter in arteriograms. A detailed description of the optimization and curve-fitting algorithms is provided along with preliminary test results comparing various approaches. The need for user demand to fuel research and development in small-scale imaging systems is also discussed. PMID:2647281

  15. Development of the Computerized Model of Performance-Based Measurement System to Measure Nurses' Clinical Competence.

    PubMed

    Liou, Shwu-Ru; Liu, Hsiu-Chen; Tsai, Shu-Ling; Cheng, Ching-Yu; Yu, Wei-Chieh; Chu, Tsui-Ping

    2016-04-01

    Critical thinking skills and clinical competence are for providing quality patient care. The purpose of this study is to develop the Computerized Model of Performance-Based Measurement system based on the Clinical Reasoning Model. The system can evaluate and identify learning needs for clinical competency and be used as a learning tool to increase clinical competency by using computers. The system includes 10 high-risk, high-volume clinical case scenarios coupled with questions testing clinical reasoning, interpersonal, and technical skills. Questions were sequenced to reflect patients' changing condition and arranged by following the process of collecting and managing information, diagnosing and differentiating urgency of problems, and solving problems. The content validity and known-groups validity was established. The Kuder-Richardson Formula 20 was 0.90 and test-retest reliability was supported (r = 0.78). Nursing educators can use the system to understand students' needs for achieving clinical competence, and therefore, educational plans can be made to better prepare students and facilitate their smooth transition to a future clinical environment. Clinical nurses can use the system to evaluate their performance-based abilities and weakness in clinical reasoning. Appropriate training programs can be designed and implemented to practically promote nurses' clinical competence and quality of patient care. PMID:26829522

  16. Visceral pleural invasion in lung adenocarcinoma ≤3 cm with ground-glass opacity: a clinical, pathological and radiological study

    PubMed Central

    Zhao, Li-Lan; Xie, Hui-Kang; Zhang, Li-Ping; Zha, Jun-Yan; Zhou, Fang-Yu; Jiang, Ge-Ning

    2016-01-01

    Background Visceral pleural invasion (VPI) had been demonstrated as an aggressive sign in non-small cell lung cancers (NSCLC). However, its incidence and clinical relevance in early lung cancer showing ground glass nodules (GGNs) has not been clarified. Methods All consecutive surgically treated patients with solitary GGNs between 2009 and 2013 were reviewed retrospectively. Inclusion criteria were defined as lesions ≤3 cm with pleura abutting on computed tomography (CT) scan and pathologically confirmed NSCLC. Results Out of 156 enrolled patients, 38 had pathologically confirmed VPI. The incidence of VPI was 41.5% (27/65) if the tumor diameter was larger than 2.0 cm and 14.3% (13/91) if diameter was smaller than 2.0 cm (P<0.001). Further, the incidence was 17.4% (12/69) in pure GGNs and 32.2% (28/87) in part-solid GGNs (P=0.040). The tumor size and the nodule nodule-pleural relationship were significant predictors of positive VPI. In cases with pleural indentation, attachment, and closeness, the incidence was 38.1%, 25.5%, and 5.3%, respectively (P=0.001). All cases were PL0 and PL1, with no PL2 cases observed. Conclusions Although VPI was visible in both pure/mix GGNs, it was more common in larger (>2 cm) GGNs. The radiographic findings of nodule abutment or a pleural tag did not reliably predict or exclude VPI. In patients with GGNs, a low rate of PL2 invasion may be observed. PMID:27499970

  17. Clinical and radiological evidence to support superficial parotidectomy as the treatment of choice for chronic parotid sialadenitis: a retrospective study.

    PubMed

    Amin, M A; Bailey, B M; Patel, S R

    2001-10-01

    We present a retrospective series of 23 consecutive parotidectomies, over a 10-year period (1989-1999) for 22 patients with chronic sialadenitis unresponsive to conservative measures. There were 10 male and 12 female patients. Mean age was 52 years (range 12-72), and mean duration of symptoms 4.5 years (range 8 months-30 years). All patients had preoperative sialography and 2 had computed tomography to exclude a neoplasm. A complete superficial parotidectomy with preservation of the main duct was done in all cases. Fifteen patients developed temporary facial nerve weakness postoperatively and 7 developed Frey's syndrome. There were no cases of permanent facial nerve palsy. Nineteen patients reported complete resolution of their symptoms and 3 patients had mild persisting symptoms that did not necessitate any further treatment. Histologically there was evidence of sialadenosis in one case and benign lymphoepithelial lesion in another; the others showed evidence of chronic sialadenitis of varying degrees of severity. Fifteen patients had postoperative sialograms, of which 11 showed evidence of some filling of residual parotid gland parenchyma and in 8 patients there was filling of a normal-looking accessory lobe. In this series, superficial parotidectomy with preservation of the main duct was safe and effective, with minimal long-term complications, for most patients with chronic parotid sialadenitis that was unresponsive to conservative measures and, in some patients, it allowed some preservation of function. The potential damage to the facial nerve and the cosmetic problems associated with a total or near-total parotidectomy were avoided.

  18. Toward clinical applications of health status measures: sensitivity of scales to clinically important changes.

    PubMed

    Deyo, R A; Inui, T S

    1984-08-01

    While the validity and reliability of many newer health status instruments have been reported, few data are available regarding the sensitivity of these instruments to clinically discernible changes in patient status. We studied this feature of the Sickness Impact Profile (SIP) in a group of patients with rheumatoid arthritis, comparing it with more traditional measures of functional status (the American Rheumatism Association (ARA) functional classification and a patient self-rating scale). Four different approaches were devised to measure "sensitivity to clinical change." These involved comparisons of functional score changes with clinical changes in patient status which were independently agreed upon by both clinician and patient, and also comparisons with several clinical disease severity indicators. When applied to groups of patients, the SIP and the patient self-rating scale were modestly superior to the ARA scale, but neither the SIP nor the self-rating scale was clearly superior to the other. For considering individual patients, all of the scales were relatively insensitive, and predictive accuracy for clinically estimated change was low. New strategies for assessing sensitivity to small changes should be developed and applied to health status and functional scales. Attention to this characteristic should allow refinement of existing scales and may enhance their clinical usefulness.

  19. Studies on nursing risks and measures of clinical medication.

    PubMed

    Li, Min; Bai, Jie; Huang, Jie

    2015-09-01

    To investigate the cause analysis of clinical medication nursing risks and propose relevant nursing measures, so as to control and reduce the clinical nursing risks and reach the physical and mental safety of patients and nurses. Clinical nursing risk events with 30 cases in TCM Hospital of Zhengzhou City from June 2010 to April 2012 were underwent statistical analyses. The risk of medication error ranked the first in the direct reasons of nursing risks, accounting for a higher ratio. Moreover, the reasons of nursing risks were also involved in nonstandard operation, disease observation and other relative factors. Nurses must fully understand the relative factors of medication nursing risks, regarding the patients as their own family and always permeating the consciousness of nursing risks into the working process. PMID:26525028

  20. [The clinical utility of C-peptide measurement in diabetology].

    PubMed

    Otto-Buczkowska, Ewa

    2015-01-01

    C-peptide is produced in equal amounts to insulin and is the best measure of endogenous insulin secretion in patients with diabetes. Measurement of insulin secretion using C-peptide can be helpful in clinical practice: differences in insulin secretion are fundamental to different requirements in the treatment of diabetes. An important clinical role of C-peptide is differentiating between type 1 and type 2 diabetes. Low basal C-peptide can be considered as criterion for transferring the patients, initially diagnosed as type 2 diabetes, in the type 1 diabetes group. C-peptide level may be a good predictor of the clinical partial remission during the first year of type 1 diabetes. Latent autoimmune diabetes in adults (LADA) is a special form of diabetes that is clinically similar to type 2 diabetes but with positivity for pancreatic autoantibodies and lower C-peptide levels. The measurement of C-peptide level and of immunological markers may represent important additional tools for establishing the correct diagnosis. The natural course of these patients shows that C-peptide will decrease with time in parallel with the curve for C-peptide in classical type 1 diabetic patients. Persistence of C-peptide is an important clinical feature of MODY. It is particularly important to identify these patients as they are commonly misdiagnosed as type 1 diabetes and treated with insulin, C-peptide can be used to assist in patient selection for islet cell transplantation and post-transplant monitoring. High uncorrected fasting C-peptid in the presence of hyperglycemia may suggest insulin resistance.

  1. Measurement of quality of life in clinical trials.

    PubMed

    Kaasa, S

    1992-01-01

    Information on patients' quality of life (QOL) will give a more comprehensive evaluation of the treatment outcome than only measures of tumour response and survival. Psychosocial indicators have rarely been used in clinical trials. This may in part be explained by physicians' lack of familiarity with these measures, methodological insufficiency and a basic philosophical reason, i.e., most doctors tend to focus on curative treatment and not on palliative treatment. A series of QOL questionnaires has been validated in the last decade for use in cancer clinical trials. Selection of the optimal method in the given trial is important. The trial ought to be designed so the proportion of missing data is low. QOL should be used as an end point in selective trials with an optimal study design and with a study coordinator who is willing to collect QOL data.

  2. Novel Outcome Measures for Clinical Trials in Cystic Fibrosis

    PubMed Central

    Tiddens, Harm AWM; Puderbach, Michael; Venegas, Jose G; Ratjen, Felix; Donaldson, Scott H; Davis, Stephanie D; Rowe, Steven M; Sagel, Scott D; Higgins, Mark; Waltz, David A

    2015-01-01

    Cystic fibrosis (CF) is a common inherited condition caused by mutations in the gene encoding the CF transmembrane regulator protein. With increased understanding of the molecular mechanisms underlying CF and the development of new therapies there comes the need to develop new outcome measures to assess the disease, its progression and response to treatment. As there are limitations to the current endpoints accepted for regulatory purposes, a workshop to discuss novel endpoints for clinical trials in CF was held in Anaheim, California in November 2011. The pros and cons of novel outcome measures with potential utility for evaluation of novel treatments in CF were critically evaluated. The highlights of the 2011 workshop and subsequent advances in technologies and techniques that could be used to inform the development of clinical trial endpoints are summarized in this review. Pediatr Pulmonol. © 2014 The Authors. Pediatric Pulmonology published by Wiley Periodicals, Inc. PMID:25641878

  3. Radiological Control Manual

    SciTech Connect

    Not Available

    1993-04-01

    This manual has been prepared by Lawrence Berkeley Laboratory to provide guidance for site-specific additions, supplements, and clarifications to the DOE Radiological Control Manual. The guidance provided in this manual is based on the requirements given in Title 10 Code of Federal Regulations Part 835, Radiation Protection for Occupational Workers, DOE Order 5480.11, Radiation Protection for Occupational Workers, and the DOE Radiological Control Manual. The topics covered are (1) excellence in radiological control, (2) radiological standards, (3) conduct of radiological work, (4) radioactive materials, (5) radiological health support operations, (6) training and qualification, and (7) radiological records.

  4. INTEGRITY OF THE SUBSCAPULARIS TENDON AFTER OPEN SURGERY FOR THE TREATMENT OF ANTERIOR SHOULDER INSTABILITY: A CLINICAL AND RADIOLOGICAL EVALUATION

    PubMed Central

    Lech, Osvandré; Piluski, Paulo; Tambani, Renato; Castro, Nero; Pimentel, Gilnei

    2015-01-01

    Objective: To evaluate the integrity of the subscapularis tendon by strength, function and magnetic resonance imaging after deltopectoralis access for anterior shoulder instability. Methods: 20 patients with anterior shoulder instability have been evaluated. Minimum follow-up was 12 months, with a mean of 40 months. Only male patients were included, with a mean of age of 29 years (20 − 42 years). The patients have been submitted to physical examinations of mobility, muscular strength, Belly Test and Gerber Test. The isokinetic strength in internal and external rotation, in angular speeds of 600/s and 1800/s, for both shoulders was measured using a dynamometer. In 15 patients magnetic resonance imaging (MRI) was carried out on both shoulders for evaluating the thickness, cross-sectional area and atrophy of the subscapularis muscle. Results: A significant difference was found between torque peaks at the speed of 600/s for internal (p=0.036) and external (p=0.008) rotation. However, at 1800/s the opposite happens (internal rotation: p=0.133; external rotation: p=0.393). Subscapularis muscle thickness and area are significantly smaller than the normal side, with a deficit of 19% and 23%, respectively. According to Rowe and UCLA scores, we find excellent and good results for the majority of patients, with a mean of 88 and 31.6 points, respectively. Conclusion: Despite of the good functional results, open surgery can limit strength and reduce the thickness and the cross-sectional area of subscapularis muscle. However, the best results were found in the patients who had the dominant side operated. PMID:27004190

  5. Measurement of social capital among clinical research trainees.

    PubMed

    Primack, Brian A; Colditz, Jason B; Cohen, Elan; Switzer, Galen E; Robinson, Georgeanna F W B; Seltzer, Deborah L; Rubio, Doris M; Kapoor, Wishwa N

    2014-02-01

    While physical and human capital are established as important predictors of success among early-career clinical investigators, less is known about the role of social capital. The authors aimed to develop a brief scale to assess social capital in this population and test its reliability and validity. A three-item assessment was developed based on a conceptual framework and measures of social capital from other fields and was administered to 414 clinical research trainees at the University of Pittsburgh in 2007-2012. The measure exhibited good internal consistency reliability (α = 0.71) and a normal distribution. On a 10-point scale, mean social capital was 6.4 (SD = 1.7). Social capital was significantly associated with 7 of the 9 expected constructs: sex, age, confidence in research skills, work-related motivation, burnout, and social support. Exploratory multivariable regression analysis demonstrated that social capital was most strongly associated with higher research confidence (β = 0.35, p < 0.001), higher extrinsic motivation (β = 0.50, p = 0.003), and lower burnout (ptrend = 0.02). This three-item scale measures social capital in this population with adequate internal consistency reliability, face validity, and construct validity. This brief assessment provides a tool that may be valuable to benchmark social capital of clinical research trainees and to better contextualize programmatic and trainee outcomes. PMID:24118964

  6. Measurement of Social Capital among Clinical Research Trainees

    PubMed Central

    Primack, Brian A.; Colditz, Jason B.; Cohen, Elan; Switzer, Galen E.; Robinson, Georgeanna; Seltzer, Deborah L.; Rubio, Doris M.; Kapoor, Wishwa N.

    2013-01-01

    While physical- and human capital are established as important predictors of success among early-career clinical investigators, less is known about the role of social capital. The authors aimed to develop a brief scale to assess social capital in this population and test its reliability and validity. A three-item assessment was developed based on a conceptual framework and measures of social capital from other fields and was administered to 414 clinical research trainees at the University of Pittsburgh in 2007–2012. The measure exhibited good internal consistency reliability (α=0.71) and a normal distribution. On a 10-point scale, mean social capital was 6.4 (SD=1.7). Social capital was significantly associated with 7 of the 9 expected constructs: sex, age, confidence in research skills, work-related motivation, burnout, and social support. Exploratory multivariable regression analysis demonstrated that social capital was most strongly associated with higher research confidence (β=0.35, P<.001), higher extrinsic motivation (β=0.50, P=.003), and lower burnout (Ptrend=.02). This 3-item scale measures social capital in this population with adequate internal consistency reliability, face validity, and construct validity. This brief assessment provides a tool which may be valuable to benchmark social capital of clinical research trainees and to better contextualize programmatic and trainee outcomes. PMID:24118964

  7. Measurement of social capital among clinical research trainees.

    PubMed

    Primack, Brian A; Colditz, Jason B; Cohen, Elan; Switzer, Galen E; Robinson, Georgeanna F W B; Seltzer, Deborah L; Rubio, Doris M; Kapoor, Wishwa N

    2014-02-01

    While physical and human capital are established as important predictors of success among early-career clinical investigators, less is known about the role of social capital. The authors aimed to develop a brief scale to assess social capital in this population and test its reliability and validity. A three-item assessment was developed based on a conceptual framework and measures of social capital from other fields and was administered to 414 clinical research trainees at the University of Pittsburgh in 2007-2012. The measure exhibited good internal consistency reliability (α = 0.71) and a normal distribution. On a 10-point scale, mean social capital was 6.4 (SD = 1.7). Social capital was significantly associated with 7 of the 9 expected constructs: sex, age, confidence in research skills, work-related motivation, burnout, and social support. Exploratory multivariable regression analysis demonstrated that social capital was most strongly associated with higher research confidence (β = 0.35, p < 0.001), higher extrinsic motivation (β = 0.50, p = 0.003), and lower burnout (ptrend = 0.02). This three-item scale measures social capital in this population with adequate internal consistency reliability, face validity, and construct validity. This brief assessment provides a tool that may be valuable to benchmark social capital of clinical research trainees and to better contextualize programmatic and trainee outcomes.

  8. Comparison of Clinical and Radiological Improvement Between the Modified Trephine and High-speed Drill as Main Osteotomy Instrument in Pedicle Subtraction Osteotomy

    PubMed Central

    Wang, Hui; Ma, Lei; Yang, Dalong; Zhang, Di; Shen, Yong; Ding, Wenyuan

    2015-01-01

    Abstract High-speed drill is the main osteotomy instrument in pedicle subtraction osteotomy (PSO) currently. Considering the long duration of surgery, the large amount of blood loss, and the high incidence of neurovascular injury, the osteotomy procedure is challenging. Use of trephine for the osteotomy displays high efficiency by shortening surgery time and reducing blood loss in anterior cervical corpectomy and fusion. However, the potential risk of neurological injury is high. We modified the trephine by adding locking instrument, when the serrated top of the trephine reaches the tip of the probe; the locking instrument on the probe restricts the trephine and improves security during the osteotomy procedure. The aim of this study was to compare the clinical and radiological improvement between the modified trephine and high-speed drill as main osteotomy instrument in PSO. From February 2009 to 2013, 50 patients with severe thoracolumbar kyphotic deformity caused by old compressive vertebrae were prospectively reviewed. All patients were randomly assigned to the experimental group (27 patients received PSO with modified trephine) and the control group (23 patients received PSO with high-speed drill). The clinical records were reviewed and compared for surgical time, operative blood loss, functional improvement (Oswestry Disability Index), and pain relief (visual analog scale). The radiological records were reviewed and compared for correction of kyphotic deformity postoperatively and correction loss at 2-year follow-up. All patients successfully finished the PSO procedure, and got satisfactory kyphotic deformity correction and overall function improvement. The surgery time was shorter in the experimental group than that in the control group (132.7 ± 12.6 vs 141.7 ± 16.7 min; P = 0.03). No significant difference was found in blood loss (882.9 ± 98.9 mL vs 902.2 ± 84.9 mL; P = 0.47) or correction of the kyphotic angle (33.4

  9. Comparison of Clinical and Radiological Improvement Between the Modified Trephine and High-speed Drill as Main Osteotomy Instrument in Pedicle Subtraction Osteotomy.

    PubMed

    Wang, Hui; Ma, Lei; Yang, Dalong; Zhang, Di; Shen, Yong; Ding, Wenyuan

    2015-11-01

    High-speed drill is the main osteotomy instrument in pedicle subtraction osteotomy (PSO) currently. Considering the long duration of surgery, the large amount of blood loss, and the high incidence of neurovascular injury, the osteotomy procedure is challenging. Use of trephine for the osteotomy displays high efficiency by shortening surgery time and reducing blood loss in anterior cervical corpectomy and fusion. However, the potential risk of neurological injury is high. We modified the trephine by adding locking instrument, when the serrated top of the trephine reaches the tip of the probe; the locking instrument on the probe restricts the trephine and improves security during the osteotomy procedure.The aim of this study was to compare the clinical and radiological improvement between the modified trephine and high-speed drill as main osteotomy instrument in PSO.From February 2009 to 2013, 50 patients with severe thoracolumbar kyphotic deformity caused by old compressive vertebrae were prospectively reviewed. All patients were randomly assigned to the experimental group (27 patients received PSO with modified trephine) and the control group (23 patients received PSO with high-speed drill). The clinical records were reviewed and compared for surgical time, operative blood loss, functional improvement (Oswestry Disability Index), and pain relief (visual analog scale). The radiological records were reviewed and compared for correction of kyphotic deformity postoperatively and correction loss at 2-year follow-up.All patients successfully finished the PSO procedure, and got satisfactory kyphotic deformity correction and overall function improvement. The surgery time was shorter in the experimental group than that in the control group (132.7 ± 12.6 vs 141.7 ± 16.7 min; P = 0.03). No significant difference was found in blood loss (882.9 ± 98.9 mL vs 902.2 ± 84.9 mL; P = 0.47) or correction of the kyphotic angle (33.4 ± 3.4° vs 32

  10. Breast Cancer EDGE Task Force Outcomes: Clinical Measures of Pain

    PubMed Central

    Harrington, Shana; Gilchrist, Laura; Sander, Antoinette

    2014-01-01

    Background Pain is one of the most commonly reported impairments after breast cancer treatment affecting anywhere from 16-73% of breast cancer survivors Despite the high reported incidence of pain from cancer and its treatments, the ability to evaluate cancer pain continues to be difficult due to the complexity of the disease and the subjective experience of pain. The Oncology Section Breast Cancer EDGE Task Force was created to evaluate the evidence behind clinical outcome measures of pain in women diagnosed with breast cancer. Methods The authors systematically reviewed the literature for pain outcome measures published in the research involving women diagnosed with breast cancer. The goal was to examine the reported psychometric properties that are reported in the literature in order to determine clinical utility. Results Visual Analog Scale, Numeric Rating Scale, Pressure Pain Threshold, McGill Pain Questionnaire, McGill Pain Questionnaire – Short Form, Brief Pain Inventory and Brief Pain Inventory – Short Form were highly recommended by the Task Force. The Task Force was unable to recommend two measures for use in the breast cancer population at the present time. Conclusions A variety of outcome measures were used to measure pain in women diagnosed with breast cancer. When assessing pain in women with breast cancer, researchers and clinicians need to determine whether a unidimensional or multidimensional tool is most appropriate as well as whether the tool has strong psychometric properties. PMID:25346950

  11. Outcome Measures for Artificial Pancreas Clinical Trials: A Consensus Report.

    PubMed

    Maahs, David M; Buckingham, Bruce A; Castle, Jessica R; Cinar, Ali; Damiano, Edward R; Dassau, Eyal; DeVries, J Hans; Doyle, Francis J; Griffen, Steven C; Haidar, Ahmad; Heinemann, Lutz; Hovorka, Roman; Jones, Timothy W; Kollman, Craig; Kovatchev, Boris; Levy, Brian L; Nimri, Revital; O'Neal, David N; Philip, Moshe; Renard, Eric; Russell, Steven J; Weinzimer, Stuart A; Zisser, Howard; Lum, John W

    2016-07-01

    Research on and commercial development of the artificial pancreas (AP) continue to progress rapidly, and the AP promises to become a part of clinical care. In this report, members of the JDRF Artificial Pancreas Project Consortium in collaboration with the wider AP community 1) advocate for the use of continuous glucose monitoring glucose metrics as outcome measures in AP trials, in addition to HbA1c, and 2) identify a short set of basic, easily interpreted outcome measures to be reported in AP studies whenever feasible. Consensus on a broader range of measures remains challenging; therefore, reporting of additional metrics is encouraged as appropriate for individual AP studies or study groups. Greater consistency in reporting of basic outcome measures may facilitate the interpretation of study results by investigators, regulatory bodies, health care providers, payers, and patients themselves, thereby accelerating the widespread adoption of AP technology to improve the lives of people with type 1 diabetes. PMID:27330126

  12. A clinically meaningful theory of outcome measures in rehabilitation medicine.

    PubMed

    Massof, Robert W

    2010-01-01

    Comparative effectiveness research in rehabilitation medicine requires the development and validation of clinically meaningful and scientifically rigorous measurements of patient states and theories that explain and predict outcomes of intervention. Patient traits are latent (unobservable) variables that can be measured only by inference from observations of surrogate manifest (observable) variables. In the behavioral sciences, latent variables are analogous to intensive physical variables such as temperature and manifest variables are analogous to extensive physical variables such as distance. Although only one variable at a time can be measured, the variable can have a multidimensional structure that must be understood in order to explain disagreements among different measures of the same variable. The use of Rasch theory to measure latent trait variables can be illustrated with a balance scale metaphor that has randomly added variability in the weights of the objects being measured. Knowledge of the distribution of the randomly added variability provides the theoretical structure for estimating measures from ordinal observation scores (e.g., performance measures or rating scales) using statistical inference. In rehabilitation medicine, the latent variable of primary interest is the patient's functional ability. Functional ability can be estimated from observations of surrogate performance measures (e.g., speed and accuracy) or self-report of the difficulty the patient experiences performing specific activities. A theoretical framework borrowed from project management, called the Activity Breakdown Structure (ABS), guides the choice of activities for assessment, based on the patient's value judgments, to make the observations clinically meaningful. In the case of low vision, the functional ability measure estimated from Rasch analysis of activity difficulty ratings was discovered to be a two-dimensional variable. The two visual function dimensions are independent

  13. Clinical workflow for spinal curvature measurement with portable ultrasound

    NASA Astrophysics Data System (ADS)

    Tabanfar, Reza; Yan, Christina; Kempston, Michael; Borschneck, Daniel; Ungi, Tamas; Fichtinger, Gabor

    2016-03-01

    PURPOSE: Spinal curvature monitoring is essential in making treatment decisions in scoliosis. Monitoring entails radiographic examinations, however repeated ionizing radiation exposure has been shown to increase cancer risk. Ultrasound does not emit ionizing radiation and is safer for spinal curvature monitoring. We investigated a clinical sonography protocol and challenges associated with position-tracked ultrasound in spinal curvature measurement in scoliosis. METHODS: Transverse processes were landmarked along each vertebra using tracked ultrasound snapshots. The transverse process angle was used to determine the orientation of each vertebra. We tested our methodology on five patients in a local pediatric scoliosis clinic, comparing ultrasound to radiographic curvature measurements. RESULTS: Despite strong correlation between radiographic and ultrasound curvature angles in phantom studies, we encountered new challenges in the clinical setting. Our main challenge was differentiating transverse processes from ribs and other structures during landmarking. We observed up to 13° angle variability for a single vertebra and a 9.85° +/- 10.81° difference between ultrasound and radiographic Cobb angles for thoracic curvatures. Additionally, we were unable to visualize anatomical landmarks in the lumbar region where soft tissue depth was 25-35mm. In volunteers with large Cobb angles (greater than 40° thoracic and 60° lumbar), we observed spinal protrusions resulting in incomplete probe-skin contact and partial ultrasound images not suitable for landmarking. CONCLUSION: Spinal curvature measurement using tracked ultrasound is viable on phantom spine models. In the clinic, new challenges were encountered which must be resolved before a universal sonography protocol can be developed.

  14. The primary outcome measure and its importance in clinical trials.

    PubMed

    Andrade, Chittaranjan

    2015-10-01

    The primary outcome measure is the outcome that an investigator considers to be the most important among the many outcomes that are to be examined in the study. The primary outcome needs to be defined at the time the study is designed. There are 2 reasons for this: it reduces the risk of false-positive errors resulting from the statistical testing of many outcomes, and it reduces the risk of a false-negative error by providing the basis for the estimation of the sample size necessary for an adequately powered study. This article discusses the setting of the primary outcome measure, the need for it, the increased risk of false-positive and false-negative errors in secondary outcome results, how to regard articles that do not state the primary outcome, how to interpret results when secondary outcomes are statistically significant but not the primary outcome, and limitations of the concept of a primary outcome measure in clinical trial research.

  15. Otologic radiology with clinical correlations

    SciTech Connect

    Ruenes, R.; De la Cruz, A.

    1986-01-01

    The authors discuss temporal bone and adjacent structures. Chapters include imaging techniques and anatomy, congenital malformations, middle and external ear infections, otosclerosis and otospongiosis, temporal bone fractures, the facial nerve tumors of the temporal bone and skull base, tumors of the cerebellar pontine angle, and, finally, a short chapter on the newer technique of cochlear implants. Illustrations include plain radiography and multidirectional tomography. Computed tomography (CT) is included. Magnetic resonance imaging is mentioned briefly, and its importance is stressed particularly in the diagnosis of internal auditory canal and other cerebellar pontine angle tumors.

  16. Nausea: current knowledge of mechanisms, measurement and clinical impact.

    PubMed

    Kenward, Hannah; Pelligand, Ludovic; Savary-Bataille, Karine; Elliott, Jonathan

    2015-01-01

    Nausea is a subjective sensation, which often acts as a signal that emesis is imminent. It is a widespread problem that occurs as a clinical sign of disease or as an adverse effect of a drug therapy or surgical procedure. The mechanisms of nausea are complex and the neural pathways are currently poorly understood. This review summarises the current knowledge of nausea mechanisms, the available animal models for nausea research and the anti-nausea properties of commercially available anti-emetic drugs. The review also presents subjective assessment and scoring of nausea. A better understanding of the underlying mechanisms of nausea might reveal potential clinically useful biomarkers for objective measurement of nausea in species of veterinary interest.

  17. A mobile tele-radiology imaging system with JPEG2000 for an emergency care.

    PubMed

    Kim, Dong Keun; Kim, Eung Y; Yang, Kun H; Lee, Chung Ki; Yoo, Sun K

    2011-08-01

    The aim of this study was to design a tele-radiology imaging system for rapid emergency care via mobile networks and to assess the diagnostic feasibility of the Joint Photographic Experts Group 2000 (JPEG2000) radiological imaging using portable devices. Rapid patient information and image exchange is helpful to make clinical decisions. We assessed the usefulness of the mobile tele-radiology system by measuring both a quantitative method, PNSR calculation, for image qualities, and its transmission time via mobile networks in different mobile networks, respectively; code division multiple access evolution-data optimized, wireless broadband, and high-speed downlink packet access; and the feasibility of the JPEG2000 computed tomography (CT) images by qualitatively assessing with the Alberta stroke program early CT score method with 12 CT image cases (seven normal and five abnormal cases). We found that the quality of the JPEG2000 radiological images was satisfied quantitatively and was judged as acceptable qualitatively at 5:1 and 10:1 compression levels for the mobile tele-radiology imaging system. The JPEG2000-format radiological images achieved a fast transmission while maintaining a diagnosis quality on a portable device via mobile networks. Unfortunately, a PDA device, having a limited screen resolution, posed difficulties in reviewing the JPEG2000 images regardless of the compression levels. An ultra mobile PC was preferable to study the medical image. The mobile tele-radiology imaging systems supporting JPEG2000 image transmission can be applied to actual emergency care services under mobile computing environments.

  18. Developing an instrument to measure effective factors on Clinical Learning

    PubMed Central

    DADGARAN, IDEH; SHIRAZI, MANDANA; MOHAMMADI, AEEN; RAVARI, ALI

    2016-01-01

    Introduction Although nursing students spend a large part of their learning period in the clinical environment, clinical learning has not been perceived by its nature yet. To develop an instrument to measure effective factors on clinical learning in nursing students. Methods This is a mixed methods study performed in 2 steps. First, the researchers defined “clinical learning” in nursing students through qualitative content analysis and designed items of the questionnaire based on semi-structured individual interviews with nursing students. Then, as the second step, psychometric properties of the questionnaire were evaluated using the face validity, content validity, construct validity, and internal consistency evaluated on 227 students from fourth or higher semesters. All the interviews were recorded and transcribed, and then, they were analyzed using Max Qualitative Data Analysis and all of qualitative data were analyzed using SPSS 14. Results To do the study, we constructed the preliminary questionnaire containing 102 expressions. After determination of face and content validities by qualitative and quantitative approaches, the expressions of the questionnaire were reduced to 45. To determine the construct validity, exploratory factor analysis was applied. The results indicated that the maximum variance percentage (40.55%) was defined by the first 3 factors while the rest of the total variance percentage (59.45%) was determined by the other 42 factors. Results of exploratory factor analysis of this questionnaire indicated the presence of 3 instructor-staff, students, and educational related factors. Finally, 41 expressions were kept in 3 factor groups. The α-Cronbach coefficient (0.93) confirmed the high internal consistency of the questionnaire. Conclusion Results indicated that the prepared questionnaire was an efficient instrument in the study of the effective factors on clinical learning as viewed by nursing students since it involves 41 expressions and

  19. Measurement of leukocyte rheology in vascular disease: clinical rationale and methodology. International Society of Clinical Hemorheology.

    PubMed

    Wautier, J L; Schmid-Schönbein, G W; Nash, G B

    1999-01-01

    The measurement of leukocyte rheology in vascular disease is a recent development with a wide range of new opportunities. The International Society of Clinical Hemorheology has asked an expert panel to propose guidelines for the investigation of leukocyte rheology in clinical situations. This article first discusses the mechanical, adhesive and related functional properties of leukocytes (especially neutrophils) which influence their circulation, and establishes the rationale for clinically-related measurements of parameters which describe them. It is concluded that quantitation of leukocyte adhesion molecules, and of their endothelial receptors may assist understanding of leukocyte behaviour in vascular disease, along with measurements of flow resistance of leukocytes, free radical production, degranulation and gene expression. For instance, vascular cell adhesion molecule (VCAM-1) is abnormally present on endothelial cells in atherosclerosis, diabetes mellitus and inflammatory conditions. Soluble forms of intercellular adhesion molecule (ICAM-1) or VCAM can be found elevated in the blood of patients with rheumatoid arthritis or infections disease. In the second part of the article, possible technical approaches are presented and possible avenues for leukocyte rheological investigations are discussed. PMID:10517484

  20. Implementation of a Radiological Safety Coach program

    SciTech Connect

    Konzen, K.K.; Langsted, J.M.

    1998-02-01

    The Safe Sites of Colorado Radiological Safety program has implemented a Safety Coach position, responsible for mentoring workers and line management by providing effective on-the-job radiological skills training and explanation of the rational for radiological safety requirements. This position is significantly different from a traditional classroom instructor or a facility health physicist, and provides workers with a level of radiological safety guidance not routinely provided by typical training programs. Implementation of this position presents a challenge in providing effective instruction, requiring rapport with the radiological worker not typically developed in the routine radiological training environment. The value of this unique training is discussed in perspective with cost-savings through better radiological control. Measures of success were developed to quantify program performance and providing a realistic picture of the benefits of providing one-on-one or small group training. This paper provides a description of the unique features of the program, measures of success for the program, a formula for implementing this program at other facilities, and a strong argument for the success (or failure) of the program in a time of increased radiological safety emphasis and reduced radiological safety budgets.

  1. Clinical measurement of tooth wear: Tooth wear indices

    PubMed Central

    López-Frías, Francisco J.; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Llamas-Carreras, José M.

    2012-01-01

    Attrition, erosion, and abrasion result in alterations to the tooth and manifest as tooth wear. Each classification corresponds to a different process with specific clinical features. Classifications made so far have no accurate prevalence data because the indexes do not necessarily measure a specific etiology, or because the study populations can be diverse in age and characteristics. Tooth wears (attrition, erosion and abrasion) is perceived internationally as a growing problem. However, the interpretation and comparison of clinical and epidemiological studies, it is increasingly difficult because of differences in terminology and the large number of indicators/indices that have been developed for the diagnosis, classification and monitoring of the loss of dental hard tissue. These indices have been designed to identify increasing severity and are usually numerical, none have universal acceptance, complicating the evaluation of the true increase in prevalence reported. This article considers the ideal requirements for an erosion index. A literature review is conducted with the aim of analyzing the evolution of the indices used today and discuss whether they meet the clinical needs and research in dentistry. Key words:Tooth wear, tooth wear indices, attrition, erosion, abrasion, abfraction. PMID:24558525

  2. Clinical measurements analysis of multi-spectral photoplethysmograph biosensors

    NASA Astrophysics Data System (ADS)

    Asare, Lasma; Kviesis-Kipge, Edgars; Spigulis, Janis

    2014-05-01

    The developed portable multi-spectral photoplethysmograph (MS-PPG) optical biosensor device, intended for analysis of peripheral blood volume pulsations at different vascular depths, has been clinically verified. Multi-spectral monitoring was performed by means of a four - wavelengths (454 nm, 519 nm, 632 nm and 888 nm) light emitted diodes and photodiode with multi-channel signal output processing. Two such sensors can be operated in parallel and imposed on the patient's skin. The clinical measurements confirmed ability to detect PPG signals at four wavelengths simultaneously and to record temporal differences in the signal shapes (corresponding to different penetration depths) in normal and pathological skin. This study analyzed wavelengths relations between systole and diastole peak difference at various tissue depths in normal and pathological skin. The difference between parameters of healthy and pathological skin at various skin depths could be explain by oxy- and deoxyhemoglobin dominance at different wavelengths operated in sensor. The proposed methodology and potential clinical applications in dermatology for skin assessment are discussed.

  3. [Measurement of blood pressure variability and the clinical value].

    PubMed

    Kékes, Ede; Kiss, István

    2014-10-19

    Authors have collected and analyzed literature data on blood pressure variability. They present the methods of blood pressure variability measurement, clinical value and relationships with target organ damages and risk of presence of cardiovascular events. They collect data about the prognostic value of blood pressure variability and the effects of different antihypertensive drugs on blood pressure variability. They underline that in addition to reduction of blood pressure to target value, it is essential to influence blood pressure fluctuation and decrease blood pressure variability, because blood pressure fluctuation presents a major threat for the hypertensive subjects. Data from national studies are also presented. They welcome that measurement of blood pressure variability has been included in international guidelines.

  4. Summary measures for clinical gait analysis: a literature review.

    PubMed

    Cimolin, Veronica; Galli, Manuela

    2014-04-01

    Instrumented 3D-gait analysis (3D-GA) is an important method used to obtain information that is crucial for establishing the level of functional limitation due to pathology, observing its evolution over time and evaluating rehabilitative intervention effects. However, a typical 3D-GA evaluation produces a vast amount of data, and despite its objectivity, its use is complicated, and the data interpretation is difficult. It is even more difficult to obtain an overview on patient cohorts for a comparison. Moreover, there is a growing awareness of the need for a concise index, specifically, a single measure of the 'quality' of a particular gait pattern. Several gait summary measures, which have been used in conjunction with 3D-GA, have been proposed to objectify clinical impression, quantify the degree of gait deviation from normal, stratify the severity of pathology, document the changes in gait patterns over time and evaluate interventions.

  5. [Virtual organization in the digital age of radiology - principle and solution for radiologic research?].

    PubMed

    Leppek, R; Krass, S; Bourquain, H; Lang, M; Wein, B; Mildenberger, P; Schaller, S; Klose, K J; Peitgen, H-O

    2003-11-01

    The research project "VICORA - Virtual Institute for Computer-Assisted Radiology", funded by the German Federal Ministry of Education and Research, was initiated in the year 2000. Its virtual organization brings together physical science, engineering, information technology, clinical radiology and the medical technology industry. In the German radiology research domain VICORA serves as a model for interdisciplinary collaboration for the changing radiology paradigm illustrated by a "radiologycube". The project does not only aim at scientific goals but also considers the infrastructure, components and human resource management within a virtual organization. The common rapid prototyping platform ILAB 4 ensures user-friendly and time-efficient software that assists with the routine radiology work-flow including full DICOM functionality. By offering a new work environment and collaborative culture based on telematics and knowledge exchange in radiology research, VICORA overcomes limitations of traditional research organization. PMID:14610709

  6. Society of Interventional Radiology

    MedlinePlus

    ... comments to CMS on two MACRA coding issues; society is engaged with CMS as they develop codes ... radiology case studies Developed by ACR Copyright © 2016 Society of Interventional Radiology. All rights reserved. 3975 Fair ...

  7. Common Interventional Radiology Procedures

    MedlinePlus

    ... of common interventional techniques is below. Common Interventional Radiology Procedures Angiography An X-ray exam of the ... into the vertebra. Copyright © 2016 Society of Interventional Radiology. All rights reserved. 3975 Fair Ridge Drive • Suite ...

  8. Models and Measurements: Complementary Tools for Predicting Atmospheric Dispersion and Assessing the Consequences of Nuclear and Radiological Emergencies

    SciTech Connect

    Bradley, M M; Kosovic, B; Nasstrom, J S

    2005-11-07

    Since its inception over 26 years ago, NARAC (the National Atmospheric Release and Advisory Center) has used measurement data to update model predictions of radioactive releases from known origins. NARAC continues to routinely participate in emergency response drills with organizations that collect air concentration, ground deposition, and radiation exposure measurements. From a complementary perspective, NARAC is now developing an advanced capability to combine models and data from monitoring systems to characterize and forensically reconstruct atmospheric release events of unknown origin.

  9. The evaluation of a clinical thermometer for measuring developer temperature in automatic film processors.

    PubMed

    Wilson, W B; Haus, A G; Nierman, C; Lillie, R; Batz, T; Moore, R

    1993-01-01

    In medical imaging, the temperature of the developer solution in the film processor affects film speed (radiation dose), film contrast, and film base plus fog. The National Council on Radiation Protection and Measurement (NCRP) Report 99 on Quality Assurance, and the American College of Radiology (ACR) Mammography Quality Control Manual for Radiologic Technologists, indicate that the developer temperature should be within +/- 0.5 degree F (+/- 0.3 degree C) of that recommended by the manufacturer for the specific film/developer combination being used. The accuracy and repeatability of the thermometer is most important. This paper describes the requirements of a thermometer for measuring the temperature of the developer solution and suggests an inexpensive but accurate device for doing so.

  10. Laboratory evaluation of a SpectraMax microplate reader and test strips for field measurement of creatinine in spot urine samples in the event of a radiological accident.

    PubMed

    Daka, Joseph N; Moodie, Gerry; Li, Chunsheng; Wilkins, Ruth; Kramer, Gary H

    2011-08-01

    The fear that terrorists might use radiological or nuclear (RN) devices to attack others is a new but growing phenomenon, arising mainly from the events of 11 September 2001. Research on rapid analytical methods that can allow analyses of large numbers of people who may become internally contaminated with radionuclides due to a RN accident is still limited. To contribute to this bioassay capacity for emergency response, the Radiation Protection Bureau of Health Canada has identified and evaluated two new portable SpectraMax plate readers (model 250 and Plus 384) and one brand of dry reagent strips for rapid measurement of creatinine in spot urine samples. Concentrations of creatinine in spot urine samples provide a means of adjusting or normalizing urine collections to 24 h, upon which accurate internal dose assessments due to the radionuclides can be made. Preliminary test results of the devices showed the two SpectraMax plate readers and the TECO dry creatinine reagent strips were portable, rapid and reliable for urinary creatinine measurements in spot samples, suggesting they can be used in rapid dose screening of people.

  11. SU-F-18C-10: Clinical Implementation of Radiochromic Film Based CTDI Measurements

    SciTech Connect

    Quintero, C; Seuntjens, J; Devic, S; Tomic, N; DeBlois, F

    2014-06-15

    Purpose: To evaluate accuracy and reproducibility of a radiochromic film-based protocol to measure computer tomography dose index (CTDI) as a part of annual QA on CT scanners and kV CBCT systems attached to linear accelerators. Methods: Energy dependence of Gafchromic XR-QA2(R) film model was tested over imaging beam qualities (50 – 140 kVp). Film pieces were irradiated in air to known values of air kerma in air (up to 10 cGy). Change in film reflectance was determined with an in-house written code using images produced by a flatbed document scanner. Calibration curves for each beam quality were created, and film responses for same air-kerma values were compared.Sets of film strips were placed into holes of a CTDI phantom and irradiated for several clinical scanning protocols on CT-simulators and CBCT systems. Film reflectance change was converted into dose to water and used to calculate CTDIvol values. Measured CTDIvol values were compared to tabulated CTDIvol values. Results: Average variations of ±5.2% in the mean film reflectance change were observed in the energy range of 80 to 140 keV, and 11.1% between 50 and 140 keV. The averaged measured CTDI values presented a mean variation for the same machine and protocol of 2.6%. However, measured CTDI values were in average 10% lower than tabulated CTDI values for CT-simulators, and 44% higher for CBCT systems. Conclusion: We found that in relatively broad range of beam qualities used in diagnostic radiology variation of film response is within ±5% resulting in ±15% systematic error in dose estimates if a single calibration curve is used. Relatively large discrepancy between measured and tabulated CTDI values for different protocols and imaging systems used within radiotherapy department strongly support the trend towards replacing CTDI value with equilibrium dose measurement in the center of cylindrical phantom as suggested by TG-111. This work was supported by the Natural Sciences and Engineering Research

  12. Measuring infant movement. Clinical and technological assessment techniques.

    PubMed

    Harris, S R; Heriza, C B

    1987-12-01

    Assessment of infant movement patterns is an important evaluation component in the early identification and management of high-risk and handicapped infants. Differences in infant movement patterns may provide early clues to the diagnosis of cerebral palsy and other developmental disabilities. The ultimate goal of early identification of movement disorders is the provision of early intervention services, such as developmental physical therapy. Qualitative analysis of infant movement differences can assist the clinician in developing treatment strategies aimed at facilitating normal movement patterns during the critical period of early central nervous system plasticity. This article presents four measurement strategies for quantifying such qualitative differences. Three clinical assessment tools--the Movement Assessment of Infants, the Bayley Motor Scale, and the Peabody Developmental Motor Scales--are described. Finally, new technological advances for kinematic analysis of infant movement are presented.

  13. Picture archiving and communication in radiology.

    PubMed

    Napoli, Marzia; Nanni, Marinella; Cimarra, Stefania; Crisafulli, Letizia; Campioni, Paolo; Marano, Pasquale

    2003-01-01

    After over 80 years of exclusive archiving of radiologic films, at present, in Radiology, digital archiving is increasingly gaining ground. Digital archiving allows a considerable reduction in costs and space saving, but most importantly, immediate or remote consultation of all examinations and reports in the hospital clinical wards, is feasible. The RIS system, in this case, is the starting point of the process of electronic archiving which however is the task of PACS. The latter can be used as radiologic archive in accordance with the law provided that it is in conformance with some specifications as the use of optical long-term storage media or with electronic track of change. PACS archives, in a hierarchical system, all digital images produced by each diagnostic imaging modality. Images and patient data can be retrieved and used for consultation or remote consultation by the reporting radiologist who requires images and reports of previous radiologic examinations or by the referring physician of the ward. Modern PACS owing to the WEB server allow remote access to extremely simplified images and data however ensuring the due regulations and access protections. Since the PACS enables a simpler data communication within the hospital, security and patient privacy should be protected. A secure and reliable PACS should be able to minimize the risk of accidental data destruction, and should prevent non authorized access to the archive with adequate security measures in relation to the acquired knowledge and based on the technological advances. Archiving of data produced by modern digital imaging is a problem now present also in small Radiology services. The technology is able to readily solve problems which were extremely complex up to some years ago as the connection between equipment and archiving system owing also to the universalization of the DICOM 3.0 standard. The evolution of communication networks and the use of standard protocols as TCP/IP can minimize

  14. Hospital preparedness for chemical and radiological disasters.

    PubMed

    Moore, Brooks L; Geller, Robert J; Clark, Charlotte

    2015-02-01

    Hospital planning for chemical or radiological events is essential but all too often treated as a low priority. Although some other types of disasters like hurricanes and tornadoes may be more frequent, chemical and radiological emergencies have the potential for major disruptions to clinical care. Thorough planning can mitigate the impact of a chemical or radiological event. Planning needs to include all 4 phases of an event: mitigation (preplanning), preparation, response, and recovery. Mitigation activities should include the performance of a hazards vulnerability analysis and identification of local subject-matter experts and team leaders.

  15. Hospital preparedness for chemical and radiological disasters.

    PubMed

    Moore, Brooks L; Geller, Robert J; Clark, Charlotte

    2015-02-01

    Hospital planning for chemical or radiological events is essential but all too often treated as a low priority. Although some other types of disasters like hurricanes and tornadoes may be more frequent, chemical and radiological emergencies have the potential for major disruptions to clinical care. Thorough planning can mitigate the impact of a chemical or radiological event. Planning needs to include all 4 phases of an event: mitigation (preplanning), preparation, response, and recovery. Mitigation activities should include the performance of a hazards vulnerability analysis and identification of local subject-matter experts and team leaders. PMID:25455661

  16. Radiological health

    SciTech Connect

    Barnes, C.M.

    1981-12-01

    Dosimeters were provided for development within the crew compartment and on the astronauts flight garments to detect radiation encountered by the space crew during the mission. The STS-1 mission encountered geomagnetically trapped electrons and protons on 13 low altitude passes through the South Atlantic anomaly. The orbital inclination was such that encounters with the outer belt horn was negligible. Radiation dose to the crew from the above events was estimated to be 5 millirad. Total PDL measured dose to the crew from all sources during the STS-1 mission was 20 millirad.

  17. Radiology of occupational chest disease

    SciTech Connect

    Solomon, A. ); Kreel, L.

    1989-01-01

    Radiologic manifestations of occupational lung disease are summarized and classified in this book according to the ILO system. The interpretation of chest roentgenograms outlines the progression of each disease and is accompanied with clinically-oriented explanations. Some of the specific diseases covered include asbestosis, coal worker's pneumoconiosis, silicosis, non-mining inhalation of silica and silicates, beryllium induced disease, inhalation of organics and metallics, and occupationally induced asthma.

  18. AERIAL RADIOLOGICAL SURVEYS

    SciTech Connect

    Proctor, A.E.

    1997-06-09

    Measuring terrestrial gamma radiation from airborne platforms has proved to be a useful method for characterizing radiation levels over large areas. Over 300 aerial radiological surveys have been carried out over the past 25 years including U.S. Department of Energy (DOE) sites, commercial nuclear power plants, Formerly Utilized Sites Remedial Action Program/Uranium Mine Tailing Remedial Action Program (FUSRAP/UMTRAP) sites, nuclear weapons test sites, contaminated industrial areas, and nuclear accident sites. This paper describes the aerial measurement technology currently in use by the Remote Sensing Laboratory (RSL) for routine environmental surveys and emergency response activities. Equipment, data-collection and -analysis methods, and examples of survey results are described.

  19. A Digital Library of Radiology Images

    PubMed Central

    Kahn, Charles E.

    2006-01-01

    A web-based virtual library of peer-reviewed radiological images was created for use in education and clinical decision support. Images were obtained from open-access content of five online radiology journals and one e-learning web site. Figure captions were indexed by Medical Subject Heading (MeSH) codes, imaging modality, and patient age and sex. This digital library provides a new, valuable online resource. PMID:17238591

  20. A digital library of radiology images.

    PubMed

    Kahn, Charles E

    2006-01-01

    A web-based virtual library of peer-reviewed radiological images was created for use in education and clinical decision support. Images were obtained from open-access content of five online radiology journals and one e-learning web site. Figure captions were indexed by Medical Subject Heading (MeSH) codes, imaging modality, and patient age and sex. This digital library provides a new, valuable online resource.

  1. Use Of Clinical Decision Analysis In Predicting The Efficacy Of Newer Radiological Imaging Modalities: Radioscintigraphy Versus Single Photon Transverse Section Emission Computed Tomography

    NASA Astrophysics Data System (ADS)

    Prince, John R.

    1982-12-01

    Sensitivity, specificity, and predictive accuracy have been shown to be useful measures of the clinical efficacy of diagnostic tests and can be used to predict the potential improvement in diagnostic certitude resulting from the introduction of a competing technology. This communication demonstrates how the informal use of clinical decision analysis may guide health planners in the allocation of resources, purchasing decisions, and implementation of high technology. For didactic purposes the focus is on a comparison between conventional planar radioscintigraphy (RS) and single photon transverse section emission conputed tomography (SPECT). For example, positive predictive accuracy (PPA) for brain RS in a specialist hospital with a 50% disease prevalance is about 95%. SPECT should increase this predicted accuracy to 96%. In a primary care hospital with only a 15% disease prevalance the PPA is only 77% and SPECT may increase this accuracy to about 79%. Similar calculations based on published data show that marginal improvements are expected with SPECT in the liver. It is concluded that: a) The decision to purchase a high technology imaging modality such as SPECT for clinical purposes should be analyzed on an individual organ system and institutional basis. High technology may be justified in specialist hospitals but not necessarily in primary care hospitals. This is more dependent on disease prevalance than procedure volume; b) It is questionable whether SPECT imaging will be competitive with standard RS procedures. Research should concentrate on the development of different medical applications.

  2. The clinical utility of bone marker measurements in osteoporosis.

    PubMed

    Wheater, Gillian; Elshahaly, Mohsen; Tuck, Stephen P; Datta, Harish K; van Laar, Jacob M

    2013-01-01

    Osteoporosis is characterised by low bone mass and structural deterioration of bone tissue, resulting in increased fragility and susceptibility to fracture. Osteoporotic fractures are a significant cause of morbidity and mortality. Direct medical costs from such fractures in the UK are currently estimated at over two billion pounds per year, resulting in a substantial healthcare burden that is expected to rise exponentially due to increasing life expectancy. Currently bone mineral density is the WHO standard for diagnosis of osteoporosis, but poor sensitivity means that potential fractures will be missed if it is used alone. During the past decade considerable progress has been made in the identification and characterisation of specific biomarkers to aid the management of metabolic bone disease. Technological developments have greatly enhanced assay performance producing reliable, rapid, non-invasive cost effective assays with improved sensitivity and specificity. We now have a greater understanding of the need to regulate pre-analytical sample collection to minimise the effects of biological variation. However, bone turnover markers (BTMs) still have limited clinical utility. It is not routinely recommended to use BTMs to select those at risk of fractures, but baseline measurements of resorption markers are useful before commencement of anti-resorptive treatment and can be checked 3-6 months later to monitor response and adherence to treatment. Similarly, formation markers can be used to monitor bone forming agents. BTMs may also be useful when monitoring patients during treatment holidays and aid in the decision as to when therapy should be recommenced. Recent recommendations by the Bone Marker Standards Working Group propose to standardise research and include a specific marker of bone resorption (CTX) and bone formation (P1NP) in all future studies. It is hoped that improved research in turn will lead to optimised markers for the clinical management of

  3. Multidimensional Interactive Radiology Report and Analysis: standardization of workflow and reporting for renal mass tracking and quantification

    NASA Astrophysics Data System (ADS)

    Hwang, Darryl H.; Ma, Kevin; Yepes, Fernando; Nadamuni, Mridula; Nayyar, Megha; Liu, Brent; Duddalwar, Vinay; Lepore, Natasha

    2015-12-01

    A conventional radiology report primarily consists of a large amount of unstructured text, and lacks clear, concise, consistent and content-rich information. Hence, an area of unmet clinical need consists of developing better ways to communicate radiology findings and information specific to each patient. Here, we design a new workflow and reporting system that combines and integrates advances in engineering technology with those from the medical sciences, the Multidimensional Interactive Radiology Report and Analysis (MIRRA). Until recently, clinical standards have primarily relied on 2D images for the purpose of measurement, but with the advent of 3D processing, many of the manually measured metrics can be automated, leading to better reproducibility and less subjective measurement placement. Hence, we make use this newly available 3D processing in our workflow. Our pipeline is used here to standardize the labeling, tracking, and quantifying of metrics for renal masses.

  4. Clinical review: Sleep measurement in critical care patients: research and clinical implications

    PubMed Central

    Bourne, Richard S; Minelli, Cosetta; Mills, Gary H; Kandler, Rosalind

    2007-01-01

    Sleep disturbances are common in critically ill patients and have been characterised by numerous studies using polysomnography. Issues regarding patient populations, monitoring duration and timing (nocturnal versus continuous), as well as practical problems encountered in critical care studies using polysomnography are considered with regard to future interventional studies on sleep. Polysomnography is the gold standard in objectively measuring the quality and quantity of sleep. However, it is difficult to undertake, particularly in patients recovering from critical illness in an acute-care area. Therefore, other objective (actigraphy and bispectral index) and subjective (nurse or patient assessment) methods have been used in other critical care studies. Each of these techniques has its own particular advantages and disadvantages. We use data from an interventional study to compare agreement between four of these alternative techniques in the measurement of nocturnal sleep quantity. Recommendations for further developments in sleep monitoring techniques for research and clinical application are made. Also, methodological problems in studies validating various sleep measurement techniques are explored. Current Controlled Trials ISRCTN47578325. PMID:17764582

  5. Application of clinical laboratory measurements to issues of environmental health.

    PubMed

    Rej, R; Silkworth, J B; DeCaprio, A P

    1992-03-13

    Monitoring of biochemical constituents in serum is an important component in revealing potential toxicity in humans and experimental animals due to exposure to a variety of xenobiotic agents. The relative toxicity of pure compounds, usually at large doses, has helped elucidate the mode of action of these compounds and their relative risk. However, most actual cases of environmental exposure present an extensive range of components and the potential for synergistic or inhibitory interactions. In this paper we review two such environmental cases: The Love Canal chemical dump site in Niagara Falls, NY, and the transformer fire at the State Office Building in Binghamton, NY. We focus on the clinical laboratory measurements obtained in these studies (including serum glucose, triglycerides, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyltransferase, lactate dehydrogenase, sodium and potassium), their usefulness, limitations, and application to such cases. Significant alterations in serum triglyceride and alanine aminotransferase levels were found in guinea pigs due to exposure to dioxins. These two tests were useful in estimating the 'equivalent' concentration of 2,3,7,8-tetrachlorodibenzo-p-dioxin in complex chemical mixtures. PMID:1572081

  6. Socioeconomic trends in radiology.

    PubMed

    Barneveld Binkhuysen, F H

    1998-01-01

    For radiology the socioeconomic environment is a topic of increasing importance. In addition to the well-known important scientific developments in radiology such as interventional MRI, several other major trends can be recognized: (1) changes in the delivery of health care, in which all kinds of managed care are developing and will influence the practice of radiology, and (2) the process of computerization and digitization. The socioeconomic environment of radiology will be transformed by the developments in managed care, teleradiology and the integration of information systems. If radiologists want to manage future radiology departments they must have an understanding of the changes in the fields of economics and politics that are taking place and that will increasingly influence radiology. Some important and recognizable aspects of these changes will be described here. PMID:9477292

  7. Evidence-based Practice of Radiology.

    PubMed

    Lavelle, Lisa P; Dunne, Ruth M; Carroll, Anne G; Malone, Dermot E

    2015-10-01

    Current health care reform in the United States is producing a shift in radiology practice from the traditional volume-based role of performing and interpreting a large number of examinations to providing a more affordable and higher-quality service centered on patient outcomes, which is described as a value-based approach to the provision of health care services. In the 1990 s, evidence-based medicine was defined as the integration of current best evidence with clinical expertise and patient values. When these methods are applied outside internal medicine, the process is called evidence-based practice (EBP). EBP facilitates understanding, interpretation, and application of the best current evidence into radiology practice, which optimizes patient care. It has been incorporated into "Practice-based Learning and Improvement" and "Systems-based Practice," which are two of the six core resident competencies of the Accreditation Council for Graduate Medical Education and two of the 12 American Board of Radiology milestones for diagnostic radiology. Noninterpretive skills, such as systems-based practice, are also formally assessed in the "Quality and Safety" section of the American Board of Radiology Core and Certifying examinations. This article describes (a) the EBP framework, with particular focus on its relevance to the American Board of Radiology certification and maintenance of certification curricula; (b) how EBP can be integrated into a residency program; and (c) the current value and likely place of EBP in the radiology information technology infrastructure. Online supplemental material is available for this article. PMID:26466187

  8. Evidence-based Practice of Radiology.

    PubMed

    Lavelle, Lisa P; Dunne, Ruth M; Carroll, Anne G; Malone, Dermot E

    2015-10-01

    Current health care reform in the United States is producing a shift in radiology practice from the traditional volume-based role of performing and interpreting a large number of examinations to providing a more affordable and higher-quality service centered on patient outcomes, which is described as a value-based approach to the provision of health care services. In the 1990 s, evidence-based medicine was defined as the integration of current best evidence with clinical expertise and patient values. When these methods are applied outside internal medicine, the process is called evidence-based practice (EBP). EBP facilitates understanding, interpretation, and application of the best current evidence into radiology practice, which optimizes patient care. It has been incorporated into "Practice-based Learning and Improvement" and "Systems-based Practice," which are two of the six core resident competencies of the Accreditation Council for Graduate Medical Education and two of the 12 American Board of Radiology milestones for diagnostic radiology. Noninterpretive skills, such as systems-based practice, are also formally assessed in the "Quality and Safety" section of the American Board of Radiology Core and Certifying examinations. This article describes (a) the EBP framework, with particular focus on its relevance to the American Board of Radiology certification and maintenance of certification curricula; (b) how EBP can be integrated into a residency program; and (c) the current value and likely place of EBP in the radiology information technology infrastructure. Online supplemental material is available for this article.

  9. An Approach for Automatic Classification of Radiology Reports in Spanish.

    PubMed

    Cotik, Viviana; Filippo, Darío; Castaño, José

    2015-01-01

    Automatic detection of relevant terms in medical reports is useful for educational purposes and for clinical research. Natural language processing (NLP) techniques can be applied in order to identify them. In this work we present an approach to classify radiology reports written in Spanish into two sets: the ones that indicate pathological findings and the ones that do not. In addition, the entities corresponding to pathological findings are identified in the reports. We use RadLex, a lexicon of English radiology terms, and NLP techniques to identify the occurrence of pathological findings. Reports are classified using a simple algorithm based on the presence of pathological findings, negation and hedge terms. The implemented algorithms were tested with a test set of 248 reports annotated by an expert, obtaining a best result of 0.72 F1 measure. The output of the classification task can be used to look for specific occurrences of pathological findings. PMID:26262128

  10. An Approach for Automatic Classification of Radiology Reports in Spanish.

    PubMed

    Cotik, Viviana; Filippo, Darío; Castaño, José

    2015-01-01

    Automatic detection of relevant terms in medical reports is useful for educational purposes and for clinical research. Natural language processing (NLP) techniques can be applied in order to identify them. In this work we present an approach to classify radiology reports written in Spanish into two sets: the ones that indicate pathological findings and the ones that do not. In addition, the entities corresponding to pathological findings are identified in the reports. We use RadLex, a lexicon of English radiology terms, and NLP techniques to identify the occurrence of pathological findings. Reports are classified using a simple algorithm based on the presence of pathological findings, negation and hedge terms. The implemented algorithms were tested with a test set of 248 reports annotated by an expert, obtaining a best result of 0.72 F1 measure. The output of the classification task can be used to look for specific occurrences of pathological findings.

  11. Clinical Measures of Shoulder Mobility in the Professional Baseball Player.

    PubMed

    Downar, Jacquelyn M; Sauers, Eric L

    2005-03-01

    Context: Professional baseball players must achieve a delicate balance between shoulder mobility and stability to attain optimal sports performance. The sport-specific demands of repetitive overhead throwing may result in an altered mobility-stability relationship.Objective: To evaluate clinical measures of shoulder mobility in professional baseball players in order to examine differences between the throwing and the nonthrowing shoulders and to describe chronic adaptations to throwing.Design: Descriptive.Setting: The athletic training room at Maryvale Baseball Park, Phoenix, AZ.Patients or Other Participants: Twenty-seven professional baseball players (20 pitchers, 7 position players; age = 20 +/- 1.6 years, height = 190.5 +/- 4.8 cm, mass = 91.6 +/- 9.6 kg) with no previous history of shoulder or elbow injury.Main Outcome Measure(s): We recorded scapular upward rotation at 4 levels of humeral elevation in the scapular plane (rest, 60 degrees , 90 degrees , 120 degrees ); posterior shoulder tightness; and passive, isolated glenohumeral joint internal and external range of motion.Results: Scapular upward rotation was significantly greater in the throwing shoulder (14.2 +/- 6.5 degrees ) than in the nonthrowing shoulder (10.6 +/- 6.1 degrees ) at 90 degrees of humeral elevation (P = .04). We observed no statistically significant difference in posterior shoulder tightness between the throwing (30.2 +/- 4.6 cm) and the nonthrowing (28.0 +/- 4.8 cm) shoulder (P = .09). In addition, the throwing shoulder exhibited a statistically significant decrease in isolated glenohumeral internal rotation (56.6 +/- 12.5 degrees ) compared with the nonthrowing shoulder (68.6 +/- 12.6 degrees ) (P = .001), with a concomitant increase in isolated glenohumeral external rotation (throwing = 108.9 +/- 9.0 degrees , nonthrowing = 101.9 +/- 5.9 degrees , P = .0014). An analysis of the total arc of motion (internal rotation + external rotation) revealed no statistically significant

  12. Imaging and radiology

    MedlinePlus

    ... imaging or a PET scan Ultrasound INTERVENTIONAL RADIOLOGY Interventional radiologists are doctors that use imaging such as CT, ultrasound, MRI and fluoroscopy to help guide procedures. The imaging ...

  13. Radiological evaluation of dysphagia

    SciTech Connect

    Ott, D.J.; Gelfand, D.W.; Wu, W.C.; Chen, Y.M.

    1986-11-21

    Dysphagia is a common complaint in patients presenting for radiological or endoscopic examination of the esophagus and is usually due to functional or structural abnormalities of the esophageal body or esophagogastric region. The authors review the radiological evaluation of the esophagus and esophagogastric region in patients with esophageal dysphagia and discuss the roentgenographic techniques used, radiological efficacy for common structural disorders, and evaluation of esophageal motor function. Comparison is made with endoscopy in assessing dysphagia, with the conclusion that the radiological examination be used initially in patients with this complaint.

  14. Thalamic Lesions: A Radiological Review

    PubMed Central

    Renard, Dimitri; Campello, Chantal; Bouly, Stephane; Le Floch, Anne; Thouvenot, Eric; Waconge, Anne; Taieb, Guillaume

    2014-01-01

    Background. Thalamic lesions are seen in a multitude of disorders including vascular diseases, metabolic disorders, inflammatory diseases, trauma, tumours, and infections. In some diseases, thalamic involvement is typical and sometimes isolated, while in other diseases thalamic lesions are observed only occasionally (often in the presence of other typical extrathalamic lesions). Summary. In this review, we will mainly discuss the MRI characteristics of thalamic lesions. Identification of the origin of the thalamic lesion depends on the exact localisation inside the thalamus, the presence of extrathalamic lesions, the signal changes on different MRI sequences, the evolution of the radiological abnormalities over time, the history and clinical state of the patient, and other radiological and nonradiological examinations. PMID:25100900

  15. The Clinical Interview and the Measurement of Conceptual Change.

    ERIC Educational Resources Information Center

    Posner, George J.; Gertzog, William A.

    1982-01-01

    Discusses the use of the clinical interview in assessing cognitive structure and in investigating conceptual change. They caution much more work is needed to increase the applicability and validity of the clinical interview method and point out that there is a lack of systematization in the analysis of interview transcripts. (Author/PB)

  16. [Development of clinical radiology in the Military field therapy Department of the Military Medical Academy (the 90th anniversary of the birth of G. I. Alekseyev)].

    PubMed

    Khalimov, Iu Sh; Vlasenko, A N; Matveev, S Iu

    2012-08-01

    On August 18, 2012, 90 years have passed since the birth of the former head of the Military field therapy Department of The Military-Medical Academy named after S. M. Kirov--the main radiologist of the Ministry of Defence of Russian Federation, the corresponding member of the Soviet Union Academy of Medical Science and the Russian Academy of Medical Science, the major- general of a medical service G. I. Alekseyev, who had been working in the department since its foundation till the last day of his life. Being the head of the department for twelve years, G. I. Alekseyev made a considerable contribution to the formation and development of native military radiology, training of medical and scientific skilled specialists. Professor G. I. Alekseyev's scientific ideas and views in the sphere of radiology were realized and developed in further educational, research and medical work of the department. Nowadays the staff of the Military field therapy Department remembers G. I. Alekseyev with special gratitude and appreciation and successfully realizes his ideas and plans in work.

  17. Characterization of a cable-free system based on p-type MOSFET detectors for 'in vivo' entrance skin dose measurements in interventional radiology

    SciTech Connect

    Falco, Maria Daniela; D'Andrea, Marco; Strigari, Lidia; D'Alessio, Daniela; Quagliani, Francesco; Santoni, Riccardo; Bosco, Alessia Lo

    2012-08-15

    Purpose: During radiological interventional procedures (RIP) the skin of a patient under examination may undergo a prolonged x-ray exposure, receiving a dose as high as 5 Gy in a single session. This paper describes the use of the OneDose{sup TM} cable-free system based on p-type MOSFET detectors to determine the entrance skin dose (ESD) at selected points during RIP. Methods: At first, some dosimetric characteristics of the detector, such as reproducibility, linearity, and fading, have been investigated using a C-arc as a source of radiation. The reference setting (RS) was: 80 kV energy, 40 cm Multiplication-Sign 40 cm field of view (FOV), current-time product of 50 mAs and source to skin distance (SSD) of 50 cm. A calibrated PMX III solid state detector was used as the reference detector and Gafchromic{sup Registered-Sign} films have been used as an independent dosimetric system to test the entire procedure. A calibration factor for the RS and correction factors as functions of tube voltage and FOV size have been determined. Results: Reproducibility ranged from 4% at low doses (around 10 cGy as measured by the reference detector) to about 1% for high doses (around 2 Gy). The system response was found to be linear with respect to both dose measured with the PMX III and tube voltage. The fading test has shown that the maximum deviation from the optimal reading conditions (3 min after a single irradiation) was 9.1% corresponding to four irradiations in one hour read 3 min after the last exposure. The calibration factor in the RS has shown that the system response at the kV energy range is about four times larger than in the MV energy range. A fifth order and fourth order polynomial functions were found to provide correction factors for tube voltage and FOV size, respectively, in measurement settings different than the RS. ESDs measured with the system after applying the proper correction factors agreed within one standard deviation (SD) with the corresponding ESDs

  18. Radiological Defense. Textbook.

    ERIC Educational Resources Information Center

    Defense Civil Preparedness Agency (DOD), Washington, DC.

    This textbook has been prepared under the direction of the Defense Civil Preparedness Agency (DCPA) Staff College for use as a student reference manual in radiological defense (RADEF) courses. It provides much of the basic technical information necessary for a proper understanding of radiological defense and summarizes RADEF planning and expected…

  19. [Radiation protection in interventional radiology].

    PubMed

    Adamus, R; Loose, R; Wucherer, M; Uder, M; Galster, M

    2016-03-01

    The application of ionizing radiation in medicine seems to be a safe procedure for patients as well as for occupational exposition to personnel. The developments in interventional radiology with fluoroscopy and dose-intensive interventions require intensified radiation protection. It is recommended that all available tools should be used for this purpose. Besides the options for instruments, x‑ray protection at the intervention table must be intensively practiced with lead aprons and mounted lead glass. A special focus on eye protection to prevent cataracts is also recommended. The development of cataracts might no longer be deterministic, as confirmed by new data; therefore, the International Commission on Radiological Protection (ICRP) has lowered the threshold dose value for eyes from 150 mSv/year to 20 mSv/year. Measurements show that the new values can be achieved by applying all X‑ray protection measures plus lead-containing eyeglasses.

  20. SU-C-18C-06: Radiation Dose Reduction in Body Interventional Radiology: Clinical Results Utilizing a New Imaging Acquisition and Processing Platform

    SciTech Connect

    Kohlbrenner, R; Kolli, KP; Taylor, A; Kohi, M; Fidelman, N; LaBerge, J; Kerlan, R; Gould, R

    2014-06-01

    Purpose: To quantify the patient radiation dose reduction achieved during transarterial chemoembolization (TACE) procedures performed in a body interventional radiology suite equipped with the Philips Allura Clarity imaging acquisition and processing platform, compared to TACE procedures performed in the same suite equipped with the Philips Allura Xper platform. Methods: Total fluoroscopy time, cumulative dose area product, and cumulative air kerma were recorded for the first 25 TACE procedures performed to treat hepatocellular carcinoma (HCC) in a Philips body interventional radiology suite equipped with Philips Allura Clarity. The same data were collected for the prior 85 TACE procedures performed to treat HCC in the same suite equipped with Philips Allura Xper. Mean values from these cohorts were compared using two-tailed t tests. Results: Following installation of the Philips Allura Clarity platform, a 42.8% reduction in mean cumulative dose area product (3033.2 versus 1733.6 mGycm∧2, p < 0.0001) and a 31.2% reduction in mean cumulative air kerma (1445.4 versus 994.2 mGy, p < 0.001) was achieved compared to similar procedures performed in the same suite equipped with the Philips Allura Xper platform. Mean total fluoroscopy time was not significantly different between the two cohorts (1679.3 versus 1791.3 seconds, p = 0.41). Conclusion: This study demonstrates a significant patient radiation dose reduction during TACE procedures performed to treat HCC after a body interventional radiology suite was converted to the Philips Allura Clarity platform from the Philips Allura Xper platform. Future work will focus on evaluation of patient dose reduction in a larger cohort of patients across a broader range of procedures and in specific populations, including obese patients and pediatric patients, and comparison of image quality between the two platforms. Funding for this study was provided by Philips Healthcare, with 5% salary support provided to authors K. Pallav

  1. Measuring service quality at a university health clinic.

    PubMed

    Anderson, E A

    1995-01-01

    Describes research undertaken to assess the quality of service provided by a public university health clinic. The SERVQUAL instrument was administered to patients of the University of Houston Health Center in order to evaluate customer perceptions of service quality. The results of this study are currently being incorporated into the clinic's strategic planning process, specifically with respect to future resource allocation towards quality improvement projects. PMID:10142015

  2. Measuring service quality at a university health clinic.

    PubMed

    Anderson, E A

    1995-01-01

    Describes research undertaken to assess the quality of service provided by a public university health clinic. The SERVQUAL instrument was administered to patients of the University of Houston Health Center in order to evaluate customer perceptions of service quality. The results of this study are currently being incorporated into the clinic's strategic planning process, specifically with respect to future resource allocation towards quality improvement projects.

  3. Measurement of physiochemical parameters and determination of the level of radiological threat to the population associated with the Karnaphuli River sediment containing municipal and industrial wastes of Chittagong city in Bangladesh.

    PubMed

    Alam, Md Kowsar; Chakraborty, Shyamal Ranjan; Rahman, Abul Khaer Mohammad Rezaur; Deb, Arun Kumar; Kamal, Masud; Chowdhury, Mantazul Islam; Uddin, Md Suza

    2013-03-01

    The research work has been aimed to assess the radiological and chemical threat caused due to urban and industrial wastage drainage to the inhabitants of the Chittagong city in Bangladesh. For finding the chemical effects along with the measurement of radiological threat, the physiochemical characteristics (temperature, pH value and oxidation-reduction potential) of the sediment samples have been analysed. The activity concentrations of naturally occurring radionuclides (238)U, (232)Th, (226)Ra and (40)K in the investigated samples have been found to be higher than those of the world average values. The artificial radionuclide (137)Cs in the samples studied has not been detected. The mean value of the radium equivalent activity and outdoor exposure rate in the study region have been found to be 240.94 ± 23.12 Bq kg(-1) and 115.82 ± 10.81 nGy h(-1), respectively. The radiation doses have been measured directly by employing beta-gamma survey meter (model: LUDLUM 44-9) from where the samples have been collected. The average values of the radiological parameters have been calculated from the activity concentrations of the radionuclides mentioned in the sediment samples found to be higher than those of the corresponding world average values.

  4. Challenges in Measuring Benefit of Clinical Research Training Programs--the ASH Clinical Research Training Institute Example.

    PubMed

    Sung, Lillian; Crowther, Mark; Byrd, John; Gitlin, Scott D; Basso, Joe; Burns, Linda

    2015-12-01

    The American Society of Hematology developed the Clinical Research Training Institute (CRTI) to address the lack of training in patient-oriented research among hematologists. As the program continues, we need to consider metrics for measuring the benefits of such a training program. This article addresses the benefits of clinical research training programs. The fundamental and key components are education and mentorship. However, there are several other benefits including promotion of collaboration, job and advancement opportunities, and promotion of work-life balance. The benefits of clinical research training programs need to be measured so that funders and society can judge if they are worth the investment in time and resources. Identification of elements that are important to program benefit is essential to measuring the benefit of the program as well as program planning. Future work should focus on the constructs which contribute to benefits of clinical research training programs such as CRTI.

  5. Design requirements for radiology workstations.

    PubMed

    Moise, Adrian; Atkins, M Stella

    2004-06-01

    This article stresses the importance of capturing feedback from representative users in the early stages of product development. We present our solution to producing quality requirement specifications for radiology workstations, specifications that remain valid over time because we successfully anticipated the industry trends and the user's needs. We present the results from a user study performed in December 1999 in a radiology clinic equipped with state-of-the-art Picture Archiving and Communications Systems (PACS) and imaging scanners. The study involved eight radiologists who answered questions and provided comments on three complementary research topics. First, we asked our subjects to enumerate the advantages and the disadvantages for both softcopy and hardcopy reading. We identified the two major factors for productivity improvement through the use of PACS workstations: workflow re-engineering and process automation. Second, we collected radiologist feedback on the use of hanging protocols (HPs). The results indicated the high importance of automatic image organization through HPs, with the potential effect of reducing the interpretation time by 10-20%. Our subjects estimated that 10-15 HPs would cover about 85%-95% of the regular radiological examinations. Third, we investigated the impact of the display devices on the radiologist's workflow. Our results indicated that the number and the properties of the monitors is a modality-specific requirement. The main results from this study on key functional requirements for softcopy interpretation only recently were incorporated in most of the current, successful PACS workstations.

  6. [Technological advances: the coming radiology].

    PubMed

    García, César; Ortega, Dulia

    2002-06-01

    We are living in a changing world, acknowledging all kinds of changes: social, technological, and ethical. This is the environment encircling medical and radiological work: demanding, with high expectations and a cohort of amazing technological advances, in all areas of human knowledge. We need to make the necessary reflections about these faster and faster changes. Radiology, as an important part of clinical work, is facing no minor challenges: technological and other most prevalent like: Who will be specialists in the next future? How are we prepared to face the radiological teaching and formation of radiologists? How to finance this technological developments? Meanwhile, in our context of an underdeveloped country, this sounds as far as the Moon, but changes will reach us sooner or later. We must resolve some problems that are a little bit more basic, such as a good level of education and health care for our people, then we will be ready to incorporate some of these amazing new technologies. PMID:12194695

  7. [The balanced scorecard--applications in a radiology department].

    PubMed

    Maurer, M H; Teichgräber, U; Kröncke, T J; Hamm, B; Lemke, A J

    2012-12-01

    The balanced scorecard (BSC) represents a comprehensive management tool for organizations with the aim to focus all activities on a chosen strategy. Targets for various perspectives of the environment such as the customer, financial, process, and potential perspective are linked with concrete measures, and cause-effect relationships between the objectives are analyzed. This article shows that the BSC can also be used for the comprehensive control of a radiology department and thus provides a meaningful contribution in organizing the various diagnostic and treatment services, the management of complex clinical environment and can be of help with the tasks in research and teaching.

  8. [The balanced scorecard--applications in a radiology department].

    PubMed

    Maurer, M H; Teichgräber, U; Kröncke, T J; Hamm, B; Lemke, A J

    2012-12-01

    The balanced scorecard (BSC) represents a comprehensive management tool for organizations with the aim to focus all activities on a chosen strategy. Targets for various perspectives of the environment such as the customer, financial, process, and potential perspective are linked with concrete measures, and cause-effect relationships between the objectives are analyzed. This article shows that the BSC can also be used for the comprehensive control of a radiology department and thus provides a meaningful contribution in organizing the various diagnostic and treatment services, the management of complex clinical environment and can be of help with the tasks in research and teaching. PMID:23059697

  9. Interventional Radiology of Male Varicocele: Current Status

    SciTech Connect

    Iaccarino, Vittorio Venetucci, Pietro

    2012-12-15

    Varicocele is a fairly common condition in male individuals. Although a minor disease, it may cause infertility and testicular pain. Consequently, it has high health and social impact. Here we review the current status of interventional radiology of male varicocele. We describe the radiological anatomy of gonadal veins and the clinical aspects of male varicocele, particularly the physical examination, which includes a new clinical and ultrasound Doppler maneuver. The surgical and radiological treatment options are also described with the focus on retrograde and antegrade sclerotherapy, together with our long experience with these procedures. Last, we compare the outcomes, recurrence and persistence rates, complications, procedure time and cost-effectiveness of each method. It clearly emerges from this analysis that there is a need for randomized multicentre trials designed to compare the various surgical and percutaneous techniques, all of which are aimed at occlusion of the anterior pampiniform plexus.

  10. A measure to evaluate deformable registration fields in clinical settings.

    PubMed

    Schreibmann, Eduard; Pantalone, Paul; Waller, Anthony; Fox, Tim

    2012-01-01

    Deformable registration has migrated from a research topic to a widely used clinical tool that can improve radiotherapeutic treatment accuracy by tracking anatomical changes. Although various mathematical formulations have been reported in the literature and implemented in commercial software, we lack a straightforward method to verify a given solution in routine clinical use. We propose a metric using concepts derived from vector analysis that complements the standard evaluation tools to identify unrealistic wrappings in a displacement field. At the heart of the proposed procedure is identification of vortexes in the displacement field that do not correspond to underlying anatomical changes. Vortexes are detected and their intensity quantified using the CURL operator and presented as a vortex map overlaid on the original anatomy for rapid identification of problematic regions. We show application of the proposed metric on clinical scenarios of adaptive radiotherapy and treatment response assessment, where the CURL operator quantitatively detected errors in the displacement field and identified problematic regions that were invisible to classical voxel-based evaluation methods. Unrealistic warping not visible to standard voxel-based solution assessment can produce erroneous results when the deformable solution is applied on a secondary dataset, such as dose matrix in adaptive therapy or PET data for treatment response assessment. The proposed metric for evaluating deformable registration provides increased usability and accuracy of detecting unrealistic deformable registration solutions when compared to standard intensity-based approaches. It is computationally efficient and provides a valuable platform for the clinical acceptance of image-guided radiotherapy. PMID:22955647

  11. Semi-Spontaneous Oral Text Production: Measurements in Clinical Practice

    ERIC Educational Resources Information Center

    Lind, Marianne; Kristoffersen, Kristian Emil; Moen, Inger; Simonsen, Hanne Gram

    2009-01-01

    Functionally relevant assessment of the language production of speakers with aphasia should include assessment of connected speech production. Despite the ecological validity of everyday conversations, more controlled and monological types of texts may be easier to obtain and analyse in clinical practice. This article discusses some simple…

  12. Slovenian experience from diagnostic angiography to interventional radiology

    PubMed Central

    Pavcnik, Dusan

    2014-01-01

    Background The purpose of writing this article is to document the important events and people in the first 50 years of diagnostic angiography and interventional radiology in Slovenia. During this period not only did the name of the institutions and departments change, but also its governance. Conclusions This depicted the important roles different people played at various times in the cardiovascular divisions inside and outside of the diagnostic and interventional radiology. Historical data show that Slovenian radiology has relatively immediately introduced the new methods of interventional radiology in clinical practice. PMID:25435857

  13. Medical student radiology teaching in Australia and New Zealand.

    PubMed

    Subramaniam, R M; Kim, C; Scally, P

    2007-08-01

    This study, involving 19 centres, establishes the status of medical student radiology teaching in Australia and New Zealand. It aims to document the academic and clinical staff profile involved in teaching, to indicate the methods of instructions used, to outline the available radiology library resources for medical students, to list the textbooks used in teaching and to uncover how many radiology departments are involving medical students in research. The findings can be used to plan and execute further actions that will enhance radiology teaching of medical students.

  14. Hazard control indices for radiological and non-radiological materials

    SciTech Connect

    Boothe, G.F.

    1994-12-21

    This document devises a method of comparing radiological and non-radiological hazard control levels. Such a comparison will be useful in determining the design control features for facilities that handle radioactive mixed waste. The design control features of interest are those that assure the protection of workers and the environment from unsafe airborne levels of radiological or non-radiological hazards.

  15. The disaggregation of radiology.

    PubMed

    Brant-Zawadzki, Michael N; Enzmann, Dieter R

    2008-12-01

    The authors discuss certain market and political forces buffeting the traditional structure of radiology, both in practice and in the academic setting. These forces can be, to a certain degree, disruptive and produce fragmentation of what are now integrated radiology services and specialties. The potential fallout from the current rapidly changing environment of health care, including strategies for delivering care along service lines or within discrete episodes of care, may have a profound impact on the future of radiology. Understanding the dynamics of the current environment may help plan strategies for dealing with the potential impact on our specialty. PMID:19027680

  16. Local area networks for radiology.

    PubMed

    Dwyer, S J; Mankovich, N J; Cox, G G; Bauman, R A

    1988-11-01

    This article is a tutorial on local area networks (LAN) for radiology applications. LANs are being implemented in radiology departments for the management of text and images, replacing the inflexible point-to-point wiring between two devices (computer-to-terminal). These networks enable the sharing of computers and computer devices, reduce equipment costs, and provide improved reliability. Any LAN must include items from the following four categories: transmission medium, topology, data transmission mode, and access protocol. Media for local area networks are twisted pair, coaxial, and optical fiber cables. The topology of these networks include the star, ring, bus, tree, and circuit-switching. Data transmission modes are either analog signals or digital signals. Access protocol methods include the broadcast bus system and the ring system. A performance measurement for a LAN is the throughput rate as a function of the number of active computer nodes. Standards for LANs help to ensure that products purchased from multiple manufacturers will operate successfully.

  17. Goal Attainment Scaling as a Clinical Measurement Technique in Communication Disorders: A Critical Review

    ERIC Educational Resources Information Center

    Schlosser, Ralf W.

    2004-01-01

    Evaluation of client progress is an important topic in communicative disorders research and clinical literature. Goal attainment scaling (GAS) is a technique for evaluating individual progress toward goals. Despite recognition of GAS as a clinical-outcome assessment technique in other clinical professions, the current debate on measuring client…

  18. [Estimation of uncertainty of measurement in clinical biochemistry].

    PubMed

    Enea, Maria; Hristodorescu, Cristina; Schiriac, Corina; Morariu, Dana; Mutiu, Tr; Dumitriu, Irina; Gurzu, B

    2009-01-01

    The uncertainty of measurement (UM) or measurement uncertainty is known as the parameter associated with the result of a measurement. Repeated measurements usually reveal slightly different results for the same analyte, sometimes a little higher, sometimes a little lower, because the results of a measurement are depending not only by the analyte itself, but also, by a number of error factors that could give doubts about the estimate. The uncertainty of the measurement represent the quantitative, mathematically expression of this doubt. UM is a range of measured values which is probably to enclose the true value of the measured. Calculation of UM for all types of laboratories is regularized by the ISO Guide to the Expression of Uncertainty in Measurement (abbreviated GUM) and the SR ENV 13005 : 2003 (both recognized by European Accreditation). Even if the GUM rules about UM estimation are very strictly, the offering of the result together with UM will increase the confidence of customers (patients or physicians). In this study the authors are presenting the possibilities of UM assessing in labs from our country by using the data obtained in the procedures of methods validation, during the internal and external quality control.

  19. The factor structure and psychometric properties of the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM) in Norwegian clinical and non-clinical samples

    PubMed Central

    2013-01-01

    Background The Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) is a 34-item instrument developed to monitor clinically significant change in out-patients. The CORE-OM covers four domains: well-being, problems/symptoms, functioning and risk, and sums up in two total scores: the mean of All items, and the mean of All non-risk items. The aim of this study was to examine the psychometric properties of the Norwegian translation of the CORE-OM. Methods A clinical sample of 527 out-patients from North Norwegian specialist psychiatric services, and a non-clinical sample of 464 persons were obtained. The non-clinical sample was a convenience sample consisting of friends and family of health personnel, and of students of medicine and clinical psychology. Students also reported psychological stress. Exploratory factor analysis (EFA) was employed in half the clinical sample. Confirmatory (CFA) factor analyses modelling the theoretical sub-domains were performed in the remaining half of the clinical sample. Internal consistency, means, and gender and age differences were studied by comparing the clinical and non-clinical samples. Stability, effect of language (Norwegian versus English), and of psychological stress was studied in the sub-sample of students. Finally, cut-off scores were calculated, and distributions of scores were compared between clinical and non-clinical samples, and between students reporting stress or no stress. Results The results indicate that the CORE-OM both measures general (g) psychological distress and sub-domains, of which risk of harm separates most clearly from the g factor. Internal consistency, stability and cut-off scores compared well with the original English version. No, or only negligible, language effects were found. Gender differences were only found for the well-being domain in the non-clinical sample and for the risk domain in the clinical sample. Current patient status explained differences between clinical and non-clinical

  20. The measurement of performance in a physical therapy clinical program. A ROI approach.

    PubMed

    Harp, Scott S

    2004-01-01

    This research presents the development and implementation of a measurement model that yields the return on investment (ROI) in a physical therapy clinical program. A performance measurement model was constructed, which determined the ROI of a clinical program in physical therapy using revenue, patient outcomes, staff productivity, costs, and patient satisfaction. Implementation used archival data for 2 groups of patients in a back and neck rehabilitation program. An expert panel was formed to review the model. Based on the results, ROI provided a more comprehensive tool to measure performance than traditional evaluation measures. ROI appears beneficial, making it a useful tool for health care professionals to measure the performance of PT clinical programs.

  1. Consistency between Self-Reported and Recorded Values for Clinical Measures

    PubMed Central

    III, Joseph Thomas; Paulet, Mindy; Rajpura, Jigar R.

    2016-01-01

    Objectives. This study evaluated consistency between self-reported values for clinical measures and recorded clinical measures. Methods. Self-reported values were collected for the clinical measures: systolic blood pressure, diastolic blood pressure, glucose level, height, weight, and cholesterol from health risk assessments completed by enrollees in a privately insured cohort. Body mass index (BMI) was computed from reported height and weight. Practitioner recorded values for the clinical measures were obtained from health screenings. We used bivariate Pearson correlation analysis and descriptive statistics to evaluate consistency between self-reported data and recorded clinic measurements. Results. There was high correlation between self-reported clinical values and recorded clinical measures for diastolic blood pressure (r = 0.91, P = <0.0001), systolic blood pressure (r = 0.93, P = <0.0001), cholesterol (r = 0.97, P = <0.0001), body mass index (r = 0.96, P = <0.0001), glucose (r = 0.96, P = <0.0001), weight (r = 0.98, P = <0.0001), and height (r = 0.89, P = <0.0001). Conclusions. Self-reported clinical values for each of the eight clinical measures examined had good consistency with practitioner recorded data. PMID:26942034

  2. Lymphadenectomy in locally advanced cervical cancer study (LiLACS): Phase III clinical trial comparing surgical with radiologic staging in patients with stages IB2-IVA cervical cancer.

    PubMed

    Frumovitz, Michael; Querleu, Denis; Gil-Moreno, Antonio; Morice, Philippe; Jhingran, Anuja; Munsell, Mark F; Macapinlac, Homer A; Leblanc, Eric; Martinez, Alejandra; Ramirez, Pedro T

    2014-01-01

    Radiation treatment planning for women with locally advanced cervical cancer (stages IB2-IVA) is often based on positron emission tomography (PET). PET, however, has poor sensitivity in detecting metastases in aortocaval nodes. We have initiated a study with the objective of determining whether pre-therapeutic laparoscopic surgical staging followed by tailored chemoradiation improves survival as compared with PET/computed tomography (CT) radiologic staging alone followed by chemoradiation. This international, multicenter phase III trial will enroll 600 women with stages IB2-IVA cervical cancer and PET/CT findings showing fluorodeoxyglucose-avid pelvic nodes and fluorodeoxyglucose-negative para-aortic nodes. Eligible patients will be randomized to undergo either pelvic radiotherapy with chemotherapy (standard-of-care arm) or surgical staging via a minimally invasive extraperitoneal approach followed by tailored radiotherapy with chemotherapy (experimental arm). The primary end point is overall survival. Secondary end points are disease-free survival, short- and long-term morbidity with pre-therapeutic surgical staging, and determination of anatomic locations of metastatic para-aortic nodes in relationship to the inferior mesenteric artery. We believe this study will show that tailored chemoradiation after pre-therapeutic surgical staging improves survival as compared with chemoradiation based on PET/CT in women with stages IB2-IVA cervical cancer.

  3. Radiology capital asset management.

    PubMed

    Wagener, G N; Pridlides, A J

    1993-01-01

    Radiology administrators are expected not only to take on the ultimate accountability for meeting the needs and challenges of present day-to-day operations, but also to plan for the future. Computer Aided Facility Management (CAFM), as a tool, enables radiology managers to obtain up-to-date data to manage their services. Using Autocad on a unix-based minicomputer as the graphical base generator and integrating information from a MUMPS-based minicomputer, the CAFM process can define areas to be studied for productivity and life cycle costs. From an analysis of radiology service, management was able to make solid judgement calls for equipment replacement and facility project renovation to effectively manage radiology resources.

  4. Radiologic Technology Program Standards.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. Dept. of Vocational Education.

    This publication contains statewide standards for the radiologic technology program in Georgia. The standards are divided into 12 categories; Foundations (philosophy, purpose, goals, program objectives, availability, evaluation); Admissions (admission requirements, provisional admission requirements, recruitment, evaluation and planning); Program…

  5. Clinical use of three-dimensional video measurements of eye movements

    NASA Technical Reports Server (NTRS)

    Merfeld, D. M.; Black, F. O.; Wade, S.; Paloski, W. H. (Principal Investigator)

    1998-01-01

    Noninvasive measurements of three-dimensional eye position can be accurately achieved with video methods. A case study showing the potential clinical benefit of these enhanced measurements is presented along with some thoughts about technological advances, essential for clinical application, that are likely to occur in the next several years.

  6. Successful Transformational Radiology Leaders.

    PubMed

    Douget, Karen

    2015-01-01

    Transformational radiology leaders elevate subordinates, expand self-awareness, develop lasting relationships, strive to exceed expectations, and uphold the vision and goals of the organization. In order for radiology leaders to become more transformational in their leadership style there are four fundamental elements they must learn: idealized influence, individualized consideration, inspirational motivation, and intellectual stimulation. Leaders can utilize personality and self-assessments to learn more about themselves, identify areas of strengths and weaknesses, and learn to be more effective when leading employees.

  7. Semantic information extracting system for classification of radiological reports in radiology information system (RIS)

    NASA Astrophysics Data System (ADS)

    Shi, Liehang; Ling, Tonghui; Zhang, Jianguo

    2016-03-01

    Radiologists currently use a variety of terminologies and standards in most hospitals in China, and even there are multiple terminologies being used for different sections in one department. In this presentation, we introduce a medical semantic comprehension system (MedSCS) to extract semantic information about clinical findings and conclusion from free text radiology reports so that the reports can be classified correctly based on medical terms indexing standards such as Radlex or SONMED-CT. Our system (MedSCS) is based on both rule-based methods and statistics-based methods which improve the performance and the scalability of MedSCS. In order to evaluate the over all of the system and measure the accuracy of the outcomes, we developed computation methods to calculate the parameters of precision rate, recall rate, F-score and exact confidence interval.

  8. Clinical use of amylase clearance and isoamylase measurements.

    PubMed

    Levitt, M D

    1979-07-01

    Isoamylase determinations and measurements of the ratio of the renal clearance of amylase relative to creatinine (CAm/CCr) were employed in an attempt to improve the diagnostic accuracy of the standard amylase measurement. An elevated CAm/CCr reflects defective proximal tubular reabsorption of amylase which occurs in virtually all patients with clear-cut acute pancreatitis. However, other conditions that apparently are associated with acute defective tubular function, such as burns and diabetic acidosis, may cause an elevated ratio. Thus, elevations of CAm/CCr cannot be considered to be specific for acute pancreatitis. Pancreatic isoamylase represents, on the average, about 33% of the normal serum amylase activity, whereas about 66% is salivary-type isoamylase. Isoamylase measurements are useful in determining whether an elevated value for serum amylase activity is of pancreatic origin. However, this measurement is not useful for determining whether patients with normal serum amylase activity have pancreatitis.

  9. Evaluation of measurement uncertainty of glucose in clinical chemistry.

    PubMed

    Berçik Inal, B; Koldas, M; Inal, H; Coskun, C; Gümüs, A; Döventas, Y

    2007-04-01

    The definition of the uncertainty of measurement used in the International Vocabulary of Basic and General Terms in Metrology (VIM) is a parameter associated with the result of a measurement, which characterizes the dispersion of the values that could reasonably be attributed to the measurand. Uncertainty of measurement comprises many components. In addition to every parameter, the measurement uncertainty is that a value should be given by all institutions that have been accredited. This value shows reliability of the measurement. GUM, published by NIST, contains uncertainty directions. Eurachem/CITAC Guide CG4 was also published by Eurachem/CITAC Working Group in the year 2000. Both of them offer a mathematical model, for uncertainty can be calculated. There are two types of uncertainty in measurement. Type A is the evaluation of uncertainty through the statistical analysis and type B is the evaluation of uncertainty through other means, for example, certificate reference material. Eurachem Guide uses four types of distribution functions: (1) rectangular distribution that gives limits without specifying a level of confidence (u(x)=a/ radical3) to a certificate; (2) triangular distribution that values near to the same point (u(x)=a/ radical6); (3) normal distribution in which an uncertainty is given in the form of a standard deviation s, a relative standard deviation s/ radicaln, or a coefficient of variance CV% without specifying the distribution (a = certificate value, u = standard uncertainty); and (4) confidence interval.

  10. Measuring Cognitive Errors Using the Cognitive Distortions Scale (CDS): Psychometric Properties in Clinical and Non-Clinical Samples

    PubMed Central

    Özdel, Kadir; Taymur, Ibrahim; Guriz, Seher Olga; Tulaci, Riza Gökcer; Kuru, Erkan; Turkcapar, Mehmet Hakan

    2014-01-01

    The Cognitive Distortions Scale was developed to assess thinking errors using case examples in two domains: interpersonal and personal achievement. Although its validity and reliability has been previously demonstrated in non-clinical samples, its psychometric properties and scoring has not yet been evaluated. The aim of the current study was to evaluate the psychometric properties of the Cognitive Distortions Scale in two Turkish samples and to examine the usefulness of the categorical scoring system. A total of 325 individuals (Sample 1 and Sample 2) were enrolled in this study to assess those psychometric properties. Our Sample 1 consisted of 225 individuals working as interns at the Diskapi Yildirim Beyazit Teaching and Research Hospital and Sample 2 consisted of 100 patients diagnosed with depression presenting to the outpatient unit of the same Hospital. Construct validity was assessed using the Beck Depression Inventory, the State Trait Anxiety Inventory, the Dysfunctional Attitude Scale, and the Automatic Thought Questionnaire. Factor analyses supported a one-factor model in these clinical and non-clinical samples. Cronbach's α values were excellent in both the non-clinical and clinical samples (0.933 and 0.918 respectively). Cognitive Distortions Scale scores showed significant correlation with relevant clinical measures. Study Cognitive Distortions Scale scores were stable over a time span of two weeks. This study showed that the Cognitive Distortions Scale is a valid and reliable measure in clinical and non-clinical populations. In addition, it shows that the categorical exists/does not exist scoring system is relevant and could be used in clinical settings. PMID:25170942

  11. Measuring cognitive errors using the Cognitive Distortions Scale (CDS): psychometric properties in clinical and non-clinical samples.

    PubMed

    Özdel, Kadir; Taymur, Ibrahim; Guriz, Seher Olga; Tulaci, Riza Gökcer; Kuru, Erkan; Turkcapar, Mehmet Hakan

    2014-01-01

    The Cognitive Distortions Scale was developed to assess thinking errors using case examples in two domains: interpersonal and personal achievement. Although its validity and reliability has been previously demonstrated in non-clinical samples, its psychometric properties and scoring has not yet been evaluated. The aim of the current study was to evaluate the psychometric properties of the Cognitive Distortions Scale in two Turkish samples and to examine the usefulness of the categorical scoring system. A total of 325 individuals (Sample 1 and Sample 2) were enrolled in this study to assess those psychometric properties. Our Sample 1 consisted of 225 individuals working as interns at the Diskapi Yildirim Beyazit Teaching and Research Hospital and Sample 2 consisted of 100 patients diagnosed with depression presenting to the outpatient unit of the same Hospital. Construct validity was assessed using the Beck Depression Inventory, the State Trait Anxiety Inventory, the Dysfunctional Attitude Scale, and the Automatic Thought Questionnaire. Factor analyses supported a one-factor model in these clinical and non-clinical samples. Cronbach's α values were excellent in both the non-clinical and clinical samples (0.933 and 0.918 respectively). Cognitive Distortions Scale scores showed significant correlation with relevant clinical measures. Study Cognitive Distortions Scale scores were stable over a time span of two weeks. This study showed that the Cognitive Distortions Scale is a valid and reliable measure in clinical and non-clinical populations. In addition, it shows that the categorical exists/does not exist scoring system is relevant and could be used in clinical settings.

  12. Knee bone tumors: findings on conventional radiology.

    PubMed

    Andrade Neto, Francisco; Teixeira, Manuel Joaquim Diógenes; Araújo, Leonardo Heráclio do Carmo; Ponte, Carlos Eduardo Barbosa

    2016-01-01

    The knee is a common site for bone tumors, whether clinically painful or not. Conventional radiology has been established as the first line of investigation in patients with knee pain and can reveal lesions that often generate questions not only for the generalist physician but also for the radiologist or general orthopedist. History, image examination, and histopathological analysis compose the essential tripod of the diagnosis of bone tumors, and conventional radiology is an essential diagnostic tool in patients with knee pain. This pictorial essay proposes to depict the main conventional radiography findings of the most common bone tumors around the knee, including benign and malignant tumors, as well as pseudo-tumors.

  13. Seeking value in Medicare: performance measurement for clinical professionals.

    PubMed

    Sprague, Lisa

    2013-10-30

    The Medicare program, despite its reputation of being a bill payer with little regard to the worth of the services it buys, has begun to put in place a range of programs aimed at assessing quality and value, with more to come. Attention to resource use and cost is nascent. The issues are complex, and it is no surprise that there is a level of contention between providers and regulators, even though both profess commitment to improved quality. This paper summarizes the quality and value programs that apply to physicians and other clinical professionals, as well as programs designed to encourage the adoption of technology to support quality improvement. Participation in all is voluntary. However, a decision not to participate increasingly carries a financial penalty, as Congress (and, by extension, the U.S. Department of Health and Human Services, or HHS) tries to encourage behavior it cannot force.

  14. Seeking value in Medicare: performance measurement for clinical professionals.

    PubMed

    Sprague, Lisa

    2013-10-30

    The Medicare program, despite its reputation of being a bill payer with little regard to the worth of the services it buys, has begun to put in place a range of programs aimed at assessing quality and value, with more to come. Attention to resource use and cost is nascent. The issues are complex, and it is no surprise that there is a level of contention between providers and regulators, even though both profess commitment to improved quality. This paper summarizes the quality and value programs that apply to physicians and other clinical professionals, as well as programs designed to encourage the adoption of technology to support quality improvement. Participation in all is voluntary. However, a decision not to participate increasingly carries a financial penalty, as Congress (and, by extension, the U.S. Department of Health and Human Services, or HHS) tries to encourage behavior it cannot force. PMID:24312987

  15. Quality management in clinical application of mass spectrometry measurement systems.

    PubMed

    Vogeser, Michael; Seger, Christoph

    2016-09-01

    Thanks to highly specific analyte detection and potentially complete compensation for matrix variables based on the principle of stable isotope derivative internal standardisation, mass spectrometry methods allow the development of diagnostic tests of outstanding analytical quality. However, these features per se do not guarantee reliability of tests. A wide range of factors can introduce analytical errors and inaccuracy due to the extreme complexity of the methods involved. Furthermore, it can be expected that the application patterns of MS methods in diagnostic laboratories will change substantially during the coming years - with presumably less specialised laboratories implementing mass spectrometry. Introduction of highly automated test solutions by manufacturers will require some trade-off between operation convenience, sample throughput and analytical performance. Structured and careful quality and risk management is therefore crucial to translate the analytical power of mass spectrometry into actionable and reliable results for individual patients' care and to maintain the degree of reliability that is expected from MS methods in clinical pathology. This reflection review discusses whether particular quality assurance tools have to be applied for MS-based diagnostic tests and whether these tools are different from those applied for optical- and affinity-based standard tests. Both pre-implementation strategies and surveillance of assays with assessment of metadata in routine testing are addressed. The release of the CLSI guideline C62-A in 2014 was a substantial achievement in this context because it addresses a wide spectrum of relevant issues in quality assurance of mass spectrometry-based clinical tests. However, the translation of this best practice document into individual laboratory settings is likely to be heterogeneous.

  16. The Clinical Outcomes Assessment Toolkit: A Framework to Support Automated Clinical Records–based Outcomes Assessment and Performance Measurement Research

    PubMed Central

    D'Avolio, Leonard W.; Bui, Alex A.T.

    2008-01-01

    The Clinical Outcomes Assessment Toolkit (COAT) was created through a collaboration between the University of California, Los Angeles and Brigham and Women's Hospital to address the challenge of gathering, formatting, and abstracting data for clinical outcomes and performance measurement research. COAT provides a framework for the development of information pipelines to transform clinical data from its original structured, semi-structured, and unstructured forms to a standardized format amenable to statistical analysis. This system includes a collection of clinical data structures, reusable utilities for information analysis and transformation, and a graphical user interface through which pipelines can be controlled and their results audited by nontechnical users. The COAT architecture is presented, as well as two case studies of current implementations in the domain of prostate cancer outcomes assessment. PMID:18308990

  17. Clinical evaluation of serum alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels in patients with hepatocellular carcinoma following interventional radiology.

    PubMed

    Minakuchi, K; Murata, K; Kaminoh, T; Takada, K; Takashima, S; Nakamura, K; Onoyama, Y

    1993-01-01

    Fourteen patients with unrespectable HCC were treated with various interventional radiology (IVR) procedures. The initial therapeutic response was determined using computed tomography (CT) findings, and determinations of serum alpha-fetoprotein (AFP) and protein induced by Vitamin K absence or antagonist-II (PIVKA-II) levels. When CT studies of the initial response to IVR were compared with changes in the serum AFP and PIVKA-II levels, the AFP level was found to correlate more closely than the PIVKA-II levels. The PIVKA-II level correlated more closely than the AFP level in cases with poor response to IVR. Both of these tumor markers should be measured in combination with the diagnostic imagings for follow-up studies of IVR.

  18. Clinical measures associated with dynamic balance and functional movement.

    PubMed

    Teyhen, Deydre S; Shaffer, Scott W; Lorenson, Chelsea L; Greenberg, Moshe D; Rogers, Shay M; Koreerat, Christina M; Villena, Sarah L; Zosel, Kristen L; Walker, Michael J; Childs, John C

    2014-05-01

    Decreased balance and impaired functional movement have been linked with increased injury risk. The purpose of our study was to determine the association between specific measures of power, strength, flexibility, balance, and endurance compared with more global measures of dynamic balance, using the Y-Balance Test (YBT), and functional movement, using the functional movement screen (FMS), in healthy soldiers. Our participants (n = 64; 53 men, 11 women) were healthy active duty service members (25.2 ± 3.8 years, 25.1 ± 3.1 kg·m(-2)). Seventeen tests with 38 associated measures of strength, power, flexibility, endurance, balance, and functional measures were assessed. A significant Pearson product moment correlation (r > 0.2 and p < 0.01) was used to narrow the number of variables of interest. Two hierarchical stepwise regression analyses were performed to determine the most parsimonious set of variables associated with the YBT and FMS performance scores. Our results included a 4 variable model (F = 13.4, p < 0.001) that was associated with YBT scores (R = 0.72, R2 = 0.51). Superior performance on the YBT was associated with better performance on the FMS lunge and upper trunk mobility tests, decreased number of hops during a 6-m hop test, and greater gastrocnemius flexibility. A second 4 variable model (F = 11.813, p < 0.001) was associated with FMS scores (R = 0.70, R2 = 0.50). Superior performance on the FMS was associated with greater anterior reach on the YBT, greater distance on the crossover hop test, increased hamstring flexibility, and higher levels of self-reported function through the lower-extremity functional scale. Physical fitness leaders and clinicians could use these models to inform decision making when developing and assessing the outcomes of a personalized intervention program for those with low FMS and YBT scores. PMID:24755867

  19. Clinical measures associated with dynamic balance and functional movement.

    PubMed

    Teyhen, Deydre S; Shaffer, Scott W; Lorenson, Chelsea L; Greenberg, Moshe D; Rogers, Shay M; Koreerat, Christina M; Villena, Sarah L; Zosel, Kristen L; Walker, Michael J; Childs, John C

    2014-05-01

    Decreased balance and impaired functional movement have been linked with increased injury risk. The purpose of our study was to determine the association between specific measures of power, strength, flexibility, balance, and endurance compared with more global measures of dynamic balance, using the Y-Balance Test (YBT), and functional movement, using the functional movement screen (FMS), in healthy soldiers. Our participants (n = 64; 53 men, 11 women) were healthy active duty service members (25.2 ± 3.8 years, 25.1 ± 3.1 kg·m(-2)). Seventeen tests with 38 associated measures of strength, power, flexibility, endurance, balance, and functional measures were assessed. A significant Pearson product moment correlation (r > 0.2 and p < 0.01) was used to narrow the number of variables of interest. Two hierarchical stepwise regression analyses were performed to determine the most parsimonious set of variables associated with the YBT and FMS performance scores. Our results included a 4 variable model (F = 13.4, p < 0.001) that was associated with YBT scores (R = 0.72, R2 = 0.51). Superior performance on the YBT was associated with better performance on the FMS lunge and upper trunk mobility tests, decreased number of hops during a 6-m hop test, and greater gastrocnemius flexibility. A second 4 variable model (F = 11.813, p < 0.001) was associated with FMS scores (R = 0.70, R2 = 0.50). Superior performance on the FMS was associated with greater anterior reach on the YBT, greater distance on the crossover hop test, increased hamstring flexibility, and higher levels of self-reported function through the lower-extremity functional scale. Physical fitness leaders and clinicians could use these models to inform decision making when developing and assessing the outcomes of a personalized intervention program for those with low FMS and YBT scores.

  20. Diagnostic radiology in the tropics: technical considerations.

    PubMed

    Ng, Kwan-Hoong; McLean, Ian Donald

    2011-11-01

    An estimated two thirds of the world's population is currently without access to diagnostic radiology services, and most of them live in resource-limited tropical regions with harsh environments. Most patients are diagnosed and treated in poorly equipped government-funded hospitals and clinics that have insufficiently trained staff and are barely operational. Any available imaging equipment is likely to be functioning suboptimally and be poorly maintained. The root of the problem is usually a lack of know-how and a quality culture, combined with insufficient basic equipment and infrastructure. Radiological imaging is an essential aspect of primary care and used in the critical diagnosis and management of trauma, tuberculosis, pneumonia, acquired immunodeficiency syndrome, cancer, and other respiratory and abdominal diseases. Considerations such as quality management and infrastructure, personnel, equipment, and radiation protection and safety are important to ensure the proper functioning and rational use of a diagnostic radiology facility in the tropics.

  1. What Does Competence Entail in Interventional Radiology?

    SciTech Connect

    Ahmed, Kamran; Keeling, Aoife N.; Khan, Reenam S.; Ashrafian, Hutan; Arora, Sonal; Nagpal, Kamal; Burrill, Joshua; Darzi, Ara; Athanasiou, Thanos; Hamady, Mohamad

    2010-02-15

    Interventional radiology is a relatively new speciality and may be referred to as 'image-guided surgery without a scalpel.' Training and accreditation bodies regard interventional radiology training as being 'different' from general radiology because of the additional need for dexterity and clinical acumen. Due to the multidimensional role of an interventional radiologist, a practitioner in this discipline must have a number of the competencies of anesthetists, surgeons, and radiologists. The attributes required of an interventional radiologist are akin to those required of a surgeon. This paper gives an overview of the skills required to be a competent interventional radiologist along with a succinct introduction to methods of assessment of technical and non-technical skills.

  2. Dynamic measurements and uncertainty estimation of clinical thermometers using Monte Carlo method

    NASA Astrophysics Data System (ADS)

    Ogorevc, Jaka; Bojkovski, Jovan; Pušnik, Igor; Drnovšek, Janko

    2016-09-01

    Clinical thermometers in intensive care units are used for the continuous measurement of body temperature. This study describes a procedure for dynamic measurement uncertainty evaluation in order to examine the requirements for clinical thermometer dynamic properties in standards and recommendations. In this study thermistors were used as temperature sensors, transient temperature measurements were performed in water and air and the measurement data were processed for the investigation of thermometer dynamic properties. The thermometers were mathematically modelled. A Monte Carlo method was implemented for dynamic measurement uncertainty evaluation. The measurement uncertainty was analysed for static and dynamic conditions. Results showed that dynamic uncertainty is much larger than steady-state uncertainty. The results of dynamic uncertainty analysis were applied on an example of clinical measurements and were compared to current requirements in ISO standard for clinical thermometers. It can be concluded that there was no need for dynamic evaluation of clinical thermometers for continuous measurement, while dynamic measurement uncertainty was within the demands of target uncertainty. Whereas in the case of intermittent predictive thermometers, the thermometer dynamic properties had a significant impact on the measurement result. Estimation of dynamic uncertainty is crucial for the assurance of traceable and comparable measurements.

  3. Designing an optical bendloss sensor for clinical force measurement

    NASA Astrophysics Data System (ADS)

    Linders, David R.; Wang, Wei-Chih; Nuckley, David J.

    2009-03-01

    In current physical medicine, specific manual forces are applied to patients for diagnosis, treatment, and evaluation, but these forces remain largely qualitiative. No universal tool exists to measure these forces and display them in real-time. To provide real-time quantitative feedback to clinicians, we have developed a disposable glove with a force sensor embedded in the fingertips or palm. The sensor is based on the fiberoptic bendloss effect whereby light intensity from an infrared source is attenuated as the fiber is bent between a series of corrugated teeth. The sensor fabricated has a very low profile (10 × 7 × 1 mm) and has demonstrated high sensitivity, accuracy, range, and durability. Forces as low as 0.1 N and up to 90 N have been measured with high signal to noise ratios. Good agreement with theoretical predictions of bendloss has been demonstrated. Current trials have obtained data from 20 ACL reconstruction patients demonstrating a significant increase in range of motion recovery for patients who consistently stretch at home over those who do not.

  4. Several strategies for evaluating the objectivity of measurements in clinical research and practice

    PubMed Central

    Keating, Joseph C

    1988-01-01

    The objectivity (interexaminer reliability) of measurement in chiropractic provides a basis for judging the quality of information in clinical research and practice. Objectivity may be determined by formal measurement evaluation studies and by sampling within clinical trials. Interpretation of inter-examiner reliability requires descriptive and inferential statistics selected on the basis of the mathematical properties of data, appreciation of the clinical meaning of a particular measure, and recognition of the role of chance. Methods of data analysis include scatter-plots, contingency tables, time-series graphs, and correlational and concordance coefficients. Many kinds of objectivity evaluations are well within the capacities of private practitioners and student clinicians.

  5. Clinical Potentials for Measuring Stress in Youth with Asthma

    PubMed Central

    Schreier, Hannah M. C.; Miller, Gregory E.; Chen, Edith

    2010-01-01

    Synopsis It is well established that the course of asthma can be affected by the psychological stress an individual experiences. In this article we review literature assessing the impact of psychological stress on asthma outcomes and discuss the benefits and disadvantages of different measures for assessing stress, including subjective questionnaires, event checklists, and interview-based approaches. We further discuss the importance of taking into account the timing and chronicity of stress, as well as individuals’ subjective appraisals of stress. We suggest that while questionnaire and checklist approaches are easier to administer, interview-based stress assessments are preferable where feasible as they generate richer and more in-depth information regarding the stressors that people experience. In addition, this kind of information appears to be more robustly linked to pediatric asthma outcomes of interest. PMID:21094922

  6. [The measureable clinical signs of malnutrition: the clinical significance of body composition - bioimpedance - analysis].

    PubMed

    Török, Éva; Harsányi, László

    2014-12-21

    Undernutrition, or more precisely: malnutrition results in worse outcome in clinical practice. Recognition and treatment of different forms of malnutrition are not unconditionally easy in the daily routine, however, it could lead to significant improvement in the outcome. This review summarizes the most frequent forms of malnutrition and demonstrates the advantages of the systematic use of bioelectrical impedance analysis in patients undergoing chronic treatment either in hospitals or outpatient care. The importance of the method is still underestimated in Hungary as well as many other countries.

  7. Organizational decentralization in radiology.

    PubMed

    Aas, I H Monrad

    2006-01-01

    At present, most hospitals have a department of radiology where images are captured and interpreted. Decentralization is the opposite of centralization and means 'away from the centre'. With a Picture Archiving and Communication System (PACS) and broadband communications, transmitting radiology images between sites will be far easier than before. Qualitative interviews of 26 resource persons were performed in Norway. There was a response rate of 90%. Decentralization of radiology interpretations seems less relevant than centralization, but several forms of decentralization have a role to play. The respondents mentioned several advantages, including exploitation of capacity and competence. They also mentioned several disadvantages, including splitting professional communities and reduced contact between radiologists and clinicians. With the new technology decentralization and centralization of image interpretation are important possibilities in organizational change. This will be important for the future of teleradiology.

  8. Organizational centralization in radiology.

    PubMed

    Aas, I H Monrad

    2006-01-01

    Traditionally, hospitals have a radiology department, where images are taken and interpretation occurs. Teleradiology makes it possible to capture images in one location and transmit them elsewhere for interpretation. Organizational centralization of radiology interpretations is therefore of interest. Empirical data have been collected in qualitative interviews of 26 resource persons with substantial experience with picture archiving and communication systems and teleradiology, from 12 departments of radiology in Norway. The response rate was 90%. A total of 21 theoretically possible types of centralization of image interpretation were identified, representing combinations of three categories of geographical centralization, and seven categories of centralization according to function. Various advantages and disadvantages of centralization were identified. Organizational changes may be decisive for the future of teleradiology, but it may be wise to plan for change in small steps, since we know little about how broad future organizational changes based on teleradiology will be, or what will decide how far particular organizations will go. PMID:16438776

  9. Organizational decentralization in radiology.

    PubMed

    Aas, I H Monrad

    2006-01-01

    At present, most hospitals have a department of radiology where images are captured and interpreted. Decentralization is the opposite of centralization and means 'away from the centre'. With a Picture Archiving and Communication System (PACS) and broadband communications, transmitting radiology images between sites will be far easier than before. Qualitative interviews of 26 resource persons were performed in Norway. There was a response rate of 90%. Decentralization of radiology interpretations seems less relevant than centralization, but several forms of decentralization have a role to play. The respondents mentioned several advantages, including exploitation of capacity and competence. They also mentioned several disadvantages, including splitting professional communities and reduced contact between radiologists and clinicians. With the new technology decentralization and centralization of image interpretation are important possibilities in organizational change. This will be important for the future of teleradiology. PMID:16884560

  10. Radiology's value chain.

    PubMed

    Enzmann, Dieter R

    2012-04-01

    A diagnostic radiology value chain is constructed to define its main components, all of which are vulnerable to change, because digitization has caused disaggregation of the chain. Some components afford opportunities to improve productivity, some add value, while some face outsourcing to lower labor cost and to information technology substitutes, raising commoditization risks. Digital image information, because it can be competitive at smaller economies of scale, allows faster, differential rates of technological innovation of components, initiating a centralization-to-decentralization technology trend. Digitization, having triggered disaggregation of radiology's professional service model, may soon usher in an information business model. This means moving from a mind-set of "reading images" to an orientation of creating and organizing information for greater accuracy, faster speed, and lower cost in medical decision making. Information businesses view value chain investments differently than do small professional services. In the former model, producing a better business product will extend image interpretation beyond a radiologist's personal fund of knowledge to encompass expanding external imaging databases. A follow-on expansion with integration of image and molecular information into a report will offer new value in medical decision making. Improved interpretation plus new integration will enrich and diversify radiology's key service products, the report and consultation. A more robust, information-rich report derived from a "systems" and "computational" radiology approach will be facilitated by a transition from a professional service to an information business. Under health care reform, radiology will transition its emphasis from volume to greater value. Radiology's future brightens with the adoption of a philosophy of offering information rather than "reads" for decision making. Staunchly defending the status quo via turf wars is unlikely to constitute a

  11. VITAMIN D STATUS: MEASUREMENT, INTERPRETATION AND CLINICAL APPLICATION

    PubMed Central

    Holick, Michael F.

    2009-01-01

    Vitamin D, the sunshine vitamin, is now recognized not only for its importance of bone health in children and adults, but also for other health benefits including reducing risk of chronic diseases including autoimmune diseases, common cancer and cardiovascular disease. Vitamin D made in the skin or ingested in the diet is biologically inert and requires two successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D [25(OH)D], and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D [1,25(OH)2D]. With the identification of 25(OH)D and 1,25(OH)2D, methods were developed to measure these metabolites in the circulation. Serum 25(OH)D is the barometer for vitamin D status. Serum 1,25(OH)2D provides no information about vitamin D status and is often normal or even elevated due to secondary hyperparathyroidism associated with vitamin D deficiency. Most experts agree that 25(OH)D of < 20 ng/ml is considered to be vitamin D deficiency whereas a 25(OH)D of 21-29 ng/ml is considered to be insufficient. The goal should be to maintain both children and adults at a level > 30 ng/ml to take full advantage of all the health benefits that vitamin D provides. PMID:18329892

  12. Westinghouse radiological containment guide

    SciTech Connect

    Aitken, S.B.; Brown, R.L.; Cantrell, J.R.; Wilcox, D.P.

    1994-03-01

    This document provides uniform guidance for Westinghouse contractors on the implementation of radiological containments. This document reflects standard industry practices and is provided as a guide. The guidance presented herein is consistent with the requirements of the DOE Radiological Control Manual (DOE N 5480.6). This guidance should further serve to enable and encourage the use of containments for contamination control and to accomplish the following: Minimize personnel contamination; Prevent the spread of contamination; Minimize the required use of protective clothing and personal protective equipment; Minimize the generation of waste.

  13. Successful Transformational Radiology Leaders.

    PubMed

    Douget, Karen

    2015-01-01

    Transformational radiology leaders elevate subordinates, expand self-awareness, develop lasting relationships, strive to exceed expectations, and uphold the vision and goals of the organization. In order for radiology leaders to become more transformational in their leadership style there are four fundamental elements they must learn: idealized influence, individualized consideration, inspirational motivation, and intellectual stimulation. Leaders can utilize personality and self-assessments to learn more about themselves, identify areas of strengths and weaknesses, and learn to be more effective when leading employees. PMID:26710553

  14. Radiological worker training

    SciTech Connect

    1998-10-01

    This Handbook describes an implementation process for core training as recommended in Implementation Guide G441.12, Radiation Safety Training, and as outlined in the DOE Radiological Control Standard (RCS). The Handbook is meant to assist those individuals within the Department of Energy, Managing and Operating contractors, and Managing and Integrating contractors identified as having responsibility for implementing core training recommended by the RCS. This training is intended for radiological workers to assist in meeting their job-specific training requirements of 10 CFR 835. While this Handbook addresses many requirements of 10 CFR 835 Subpart J, it must be supplemented with facility-specific information to achieve full compliance.

  15. Update on a Clinical Measure for the Assessment of Problem Solving

    ERIC Educational Resources Information Center

    Marshall, Robert C.; Karow, Colleen M.

    2008-01-01

    Purpose: The Rapid Assessment of Problem Solving test (RAPS) is a clinical measure of problem solving based on the 20 Questions Test. This article updates clinicians on the RAPS, addresses questions raised about the test in an earlier article (R. C. Marshall, C. M. Karow, C. Morelli, K. Iden, & J. Dixon, 2003a), and discusses the clinical utility…

  16. Diagnostic measure to quantify loss of clinical components in multi-lead electrocardiogram.

    PubMed

    Tripathy, R K; Sharma, L N; Dandapat, S

    2016-03-01

    In this Letter, a novel principal component (PC)-based diagnostic measure (PCDM) is proposed to quantify loss of clinical components in the multi-lead electrocardiogram (MECG) signals. The analysis of MECG shows that, the clinical components are captured in few PCs. The proposed diagnostic measure is defined as the sum of weighted percentage root mean square difference (PRD) between the PCs of original and processed MECG signals. The values of the weight depend on the clinical importance of PCs. The PCDM is tested over MECG enhancement and a novel MECG data reduction scheme. The proposed measure is compared with weighted diagnostic distortion, wavelet energy diagnostic distortion and PRD. The qualitative evaluation is performed using Spearman rank-order correlation coefficient (SROCC) and Pearson linear correlation coefficient. The simulation result demonstrates that the PCDM performs better to quantify loss of clinical components in MECG and shows a SROCC value of 0.9686 with subjective measure. PMID:27222735

  17. Osteonecrosis of Femoral Head Treated with Extracorporeal Shock Wave Therapy: Analysis of Short-term Clinical Outcomes of Treatment with Radiologic Staging

    PubMed Central

    Lee, Jin-Young; Kwon, Jae-Woo; Park, Jung-Seob; Han, Kyeol; Shin, Woo-jin; Lee, Jeong-Gil

    2015-01-01

    Purpose To evaluate clinical results of extracorporeal shock wave therapy (ESWT) with radiographic staging on patients with avascular necrosis of femoral head (AVNFH). Materials and Methods We evaluated 24 patients diagnosed with AVNFH (32 hip joints) who were treated with ESWT from 1993 to 2012. Average follow-up period was 27 months, and the average age of patients was 47.8 years. The Association Research Circulation Osseous (ARCO) system was used to grade radiographic stage prior to treatment. For this study patients were divided into two groups based on their ARCO stage, group 1 (ARCO stages I and II) and group 2 (ARCO stage III). Comparative analyses were done between the two groups using the visual analogue scale (VAS) score and the Harris hip score (HHS) at pre-treatment and 3, 6, 12, and 24 months after treatment. Failure was defined when radiographic stage progressed or arthroplasty surgery was needed due to clinical exacerbation. Results Both groups showed clinical improvements with VAS scoring at final follow-up (group 1: median 7 to 1.5, P<0.001; group 2: mean 7 to 4, P=0.056). Using HHS, group 1 showed a significant improvement (from 65.5 to 95 [P<0.001]), while no significance was observed for group 2 (P=0.280). At final follow-up, 3 hips from group 1 and one hip from group 2 showed radiographic improvement; however, two patients underwent total hip arthroplasty due to persistent pain and dysfunction. Conclusion ESWT can be considered as an interventional option before surgical treatment in patients with not only early stage AVNFH but also with mid stage. PMID:27536633

  18. Clinical and Radiologic Evaluation of Regenerative Potential of NHA Paste and DBM in the Treatment of Periodontal Intra-bony Defects -A Randomized Control Trial

    PubMed Central

    Jain, Deepti; Gupta, Bharat; Sharma, Saurabh; Juneja, Saurabh; Juneja, Manjushree; Sharma, Shruti; Patil, Neha

    2016-01-01

    Introduction Previous studies have shown that Hydroxyapatite (HA) has shown good results in the treatment of intra-osseous periodontal defects. A newer variety of HA has been designed over a period of research which has nano-sized particles and is availed in a paste consistency called Nanocrystalline Hydroxyapatite paste (NHA paste). This variation in size and surface area of NHA paste can provide better results when used in intra-bony defects. Aim The purpose of this study was to compare the clinical and radiographic outcomes obtained with usage of NHA paste to those obtained with Demineralized Bone Matrix (DBM) in the treatment of periodontal intra-bony defects. Material and Methods A clinical trial was carried out for a period of 12 months. A total of 26 intra-bony defects in 10 patients were divided into experimental and control sites. The experimental sites were debrided and grafted with NHA paste. The control sites were debrided and grafted with DBM-Xenograft. Probing Depth, Clinical Attachment Level (DCAL) and Gingival Margin (GM) position were recorded at baseline 3, 6, 9 and 12 months. Standardized radiographs were also documented at these recalls. The results were averaged (mean± standard deviation) for each parameter and Student t-test was used to determine intra-group statistical difference and One way analyses of variance (ANOVA) to test the difference between groups using Excel and SPSS (SPSS Inc, Chicago) software packages. Results On completion of 12 months, the mean percentage of PD reduction achieved in the experimental and control sites was 67.45% and 69.03% respectively (p<0.05). The mean percentage of gain achieved in CAL was 63.58% and 61.42% in the experimental and control sites respectively (p<0.05). Gingival recession was seen to be non-significant in the experimental and control sites. The mean percentage of bone fill in the control group obtained was 48.16% where as the percentage of bone fill obtained in the experimental group was 48

  19. Current Trends in Gamma Ray Detection for Radiological Emergency Response

    SciTech Connect

    Mukhopadhyay, S., Guss, P., Maurer, R.

    2011-08-18

    Passive and active detection of gamma rays from shielded radioactive materials, including special nuclear materials, is an important task for any radiological emergency response organization. This article reports on the current trends and status of gamma radiation detection objectives and measurement techniques as applied to nonproliferation and radiological emergencies.

  20. FRMAC Interactions During a Radiological or Nuclear Event

    SciTech Connect

    Wong, C T

    2011-01-27

    During a radiological or nuclear event of national significance the Federal Radiological Emergency Monitoring and Assessment Center (FRMAC) assists federal, state, tribal, and local authorities by providing timely, high-quality predictions, measurements, analyses and assessments to promote efficient and effective emergency response for protection of the public and the environment from the consequences of such an event.

  1. Radiological Scoping Survey of the Scotia Depot Scotia, New York

    SciTech Connect

    E. N. Bailey

    2005-02-05

    At the request of the Defense Logistics Agency, the Oak Ridge Institute for Science and Education conducted radiological scoping surveys of the Scotia Depot during the period of September 24 through 27, 2007. The scoping survey included visual inspections and limited radiological surveys performed in accordance with area classification that included surface scans, total and removable activity measurements, and soil sampling.

  2. Prognostic Significance of Clinical/Pathological Stage IA Non-Small-Cell Lung Cancer Showing Partially Solid or Solid Tumours on Radiological Exam

    PubMed Central

    Matsuura, Yosuke; Nakao, Masayuki; Mun, Mingyon; Nakagawa, Ken; Ishikawa, Yuichi; Okumura, Sakae

    2015-01-01

    Purpose: Although curative resection is expected to be effective in patients with clinical (c-) stage IA/pathological (p-) stage IA non-small-cell lung cancers, recurrence is often observed. Hence, the aim of this study was to identify predictors of recurrence. Methods: Between 2005 and 2009, 138 patients with c-stage IA/p-stage IA non-small-cell lung cancers underwent resection. Recurrence and recurrence-free survival (RFS) were compared with clinical, radiographic and pathological findings. Results: The 5-year cancer-specific survival rate was 97% and the RFS rate was 89% at a median follow-up time of 91 months. Recurrence was observed in 10 patients (7.2%). Significant differences were observed in RFS according to tumour dimensions on the mediastinal window image (>1.5 cm), serum carcinoembryonic antigen levels (>5.0 ng/mL), maximum standardised uptake values (SUVmax >2.5) and angiolymphatic invasion. Patients were grouped according to the number of risk factors for poor RFS. Patients with 0–1 of the identified risk factors had an RFS of 97%, where those with 2–4 factors had an RFS of 68% (p <0.001). Conclusion: Prognosis of patients exhibiting more than two of these risk factors is considerably poor. Thus, close observation and individualised adjuvant therapy may be beneficial to these patients. PMID:25740451

  3. Breast adenomyoepithelioma and adenomyoepithelioma with carcinoma (malignant adenomyoepithelioma) with associated breast malignancies: A case series emphasizing histologic, radiologic, and clinical correlation.

    PubMed

    Moritz, August W; Wiedenhoefer, James F; Profit, Amanda P; Jagirdar, Jaishree

    2016-10-01

    The 2012 World Health Organization (WHO) classification of breast tumors distinguishes adenomyoepitheliomas (AMEs) as benign tumors composed of a biphasic proliferation of phenotypically variable myoepithelial cells around small epithelial lined spaces. Many AMEs have demonstrated benign behavior and are often cured with excision with negative margins, but some have exhibited malignant transformation of the myoepithelial cells, ductal epithelial cells, or both. When one of the components is histologically malignant, it is termed AME with carcinoma. Due to the rarity, the literature correlating imaging, histology, and clinical outcome is limited. A retrospective review was undertaken. A review of an institutional pathology database identified 14 cases with AME or malignant AME. Most AMEs had nonspecific imaging findings and were categorized as Bi-Rads 4. Histologic features of AME did not correlate with prior or concurrent breast malignancies or any radiographic features. Clinical follow up could be obtained for all but one case (mean follow up time = 75 months). 5 cases had no known treatment post-biopsy and 5 patients received mastectomy. No recurrences were noted. 3/13 cases of benign AME had associated breast malignancies including invasive ductal adenocarcinoma and ductal carcinoma in-situ. 1 case of malignant AME had a synchronous separate malignant phyllodes tumor. Given the unclear and unpredictable propensity for malignant transformation, conservative excision with negative margins currently seems appropriate. PMID:27494340

  4. 324 Building Baseline Radiological Characterization

    SciTech Connect

    R.J. Reeder, J.C. Cooper

    2010-06-24

    This report documents the analysis of radiological data collected as part of the characterization study performed in 1998. The study was performed to create a baseline of the radiological conditions in the 324 Building.

  5. The application of Rasch measurement theory to psychiatric clinical outcomes research

    PubMed Central

    Barbic, Skye P.; Cano, Stefan J.

    2016-01-01

    This commentary argues the importance of robust, meaningful assessment of clinical and functional outcomes in psychiatry. Outcome assessments should be fit for the purpose of measuring relevant concepts of interest in specific clinical settings. As well, the measurement model selected to develop and test assessments can be critical for guiding care. Three types of measurement models are presented: classical test theory, item response theory, and Rasch measurement theory. To optimise current diagnostic and treatment practices in psychiatry, careful consideration of these models is warranted.. PMID:27752341

  6. Comparison of Clinical and Radiological Results of Posterolateral Fusion and Posterior Lumbar Interbody Fusion in the Treatment of L4 Degenerative Lumbar Spondylolisthesis

    PubMed Central

    Kuraishi, Shugo; Mukaiyama, Keijiro; Shimizu, Masayuki; Ikegami, Shota; Futatsugi, Toshimasa; Hirabayashi, Hiroki; Ogihara, Nobuhide; Hashidate, Hiroyuki; Tateiwa, Yutaka; Kinoshita, Hisatoshi; Kato, Hiroyuki

    2016-01-01

    Study Design Multicenter analysis of two groups of patients surgically treated for degenerative L4 unstable spondylolisthesis. Purpose To compare the clinical and radiographic outcomes of posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) for degenerative L4 unstable spondylolisthesis. Overview of Literature Surgery for lumbar degenerative spondylolisthesis is widely performed. However, few reports have compared the outcome of PLF to that of PLIF for degenerative L4 unstable spondylolisthesis. Methods Patients with L4 unstable spondylolisthesis with Meyerding grade II or more, slip of >10° or >4 mm upon maximum flexion and extension bending, and posterior opening of >5 degree upon flexion bending were studied. Patients were treated from January 2008 to January 2010. Patients who underwent PLF (n=12) and PLIF (n=19) were followed-up for >2 years. Radiographic findings and clinical outcomes evaluated by the Japanese Orthopaedic Association (JOA) score were compared between the two groups. Radiographic evaluation included slip angle, translation, slip angle and translation during maximum flexion and extension bending, intervertebral disc height, lumbar lordotic angle, and fusion rate. Results JOA scores of the PLF group before surgery and at final follow-up were 12.3±4.8 and 24.1±3.7, respectively; those of the PLIF group were 14.7±4.8 and 24.2±7.8, respectively, with no significant difference between the two groups. Correction of slip estimated from postoperative slip angle, translation, and maintenance of intervertebral disc height in the PLIF group was significantly (p<0.05) better than those in the PLF group. However, there was no significant difference in lumbar lordotic angle, slip angle and translation angle upon maximum flexion, or extension bending. Fusion rates of the PLIF and PLF groups had no significant difference. Conclusions The L4–L5 level posterior instrumented fusion for unstable spondylolisthesis using both PLF and PLIF

  7. Paediatric musculoskeletal interventional radiology.

    PubMed

    Natali, Gian L; Paolantonio, Guglielmo; Fruhwirth, Rodolfo; Alvaro, Giuseppe; Parapatt, George K; Toma', Paolo; Rollo, Massimo

    2016-01-01

    Interventional radiology technique is now well established and widely used in the adult population. Through minimally invasive procedures, it increasingly replaces surgical interventions that involve higher percentages of invasiveness and, consequently, of morbidity and mortality. For these advantageous reasons, interventional radiology in recent years has spread to the paediatric age as well. The aim of this study was to review the literature on the development, use and perspectives of these procedures in the paediatric musculoskeletal field. Several topics are covered: osteomuscle neoplastic malignant and benign pathologies treated with invasive diagnostic and/or therapeutic procedures such as radiofrequency ablation in the osteoid osteoma; invasive and non-invasive procedures in vascular malformations; treatment of aneurysmal bone cysts; and role of interventional radiology in paediatric inflammatory and rheumatic inflammations. The positive results that have been generated with interventional radiology procedures in the paediatric field highly encourage both the development of new ad hoc materials, obviously adapted to young patients, as well as the improvement of such techniques, in consideration of the fact that childrens' pathologies do not always correspond to those of adults. In conclusion, as these interventional procedures have proven to be less invasive, with lower morbidity and mortality rates as well, they are becoming a viable and valid alternative to surgery in the paediatric population.

  8. Radiologic Technology Program Guide.

    ERIC Educational Resources Information Center

    Georgia Univ., Athens. Dept. of Vocational Education.

    This guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a radiologic technology program. The guide contains four major sections. The General Information section contains an introduction giving an overview and defining purpose and objectives; a program description,…

  9. Radiological Safety Handbook.

    ERIC Educational Resources Information Center

    Army Ordnance Center and School, Aberdeen Proving Ground, MD.

    Written to be used concurrently with the U.S. Army's Radiological Safety Course, this publication discusses the causes, sources, and detection of nuclear radiation. In addition, the transportation and disposal of radioactive materials are covered. The report also deals with the safety precautions to be observed when working with lasers, microwave…

  10. Radiological Defense Manual.

    ERIC Educational Resources Information Center

    Defense Civil Preparedness Agency (DOD), Washington, DC.

    Originally prepared for use as a student textbook in Radiological Defense (RADEF) courses, this manual provides the basic technical information necessary for an understanding of RADEF. It also briefly discusses the need for RADEF planning and expected postattack emergency operations. There are 14 chapters covering these major topics: introduction…

  11. Radiology Technician (AFSC 90370).

    ERIC Educational Resources Information Center

    Sobczak, James

    This five-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for radiology technicians. Covered in the individual volumes are radiographic fundamentals (x-ray production; primary beams; exposure devices; film, film holders, and darkrooms; control of film quality; and environmental safety);…

  12. Profound clinical and radiological response to BRAF inhibition in a 2-month-old diencephalic child with hypothalamic/chiasmatic glioma.

    PubMed

    Lassaletta, Alvaro; Guerreiro Stucklin, Ana; Ramaswamy, Vijay; Zapotocky, Michal; McKeown, Tara; Hawkins, Cynthia; Bouffet, Eric; Tabori, Uri

    2016-11-01

    Infants with low-grade glioma (LGG) have a poor survival. BRAFV600E mutation has been identified in pediatric LGG; however, the use of BRAF inhibitors in infants has never been reported. A 2-month-old with V600E mutant hypothalamic/chiasmatic glioma progressed on chemotherapy resulting in profound visual loss, massive ascites, and diencephalic syndrome. Initiation of dabrafenib resulted in rapid and sustained disappearance of clinical symptoms and a profound sustained cytoreduction. BRAF inhibition was safely tolerated with dramatic clinicoradiological response, suggesting early targeted therapy is a viable option in infants with LGG. A re-evaluation of current management paradigms in this population is warranted to leverage the potential benefit of upfront-targeted therapies.

  13. Ethical problems in radiology: radiological consumerism.

    PubMed

    Magnavita, N; Bergamaschi, A

    2009-10-01

    One of the causes of the increasing request for radiological examinations occurring in all economically developed countries is the active role played by the patient-consumer. Consumerism places the radiologist in an ethical dilemma, between the principle of autonomy on the one hand and the ethical principles of beneficence, nonmaleficence and justice on the other. The choice made by radiologists in moral dilemmas is inspired by an adherence to moral principles, which in Italy and elsewhere refer to the Judaeo-Christian tradition or to neo-Darwinian relativism. Whatever the choice, the radiologist is bound to adhere to that choice and to provide the patient with all the relevant information regarding his or her state of health.

  14. ICRP PUBLICATION 120: Radiological protection in cardiology.

    PubMed

    Cousins, C; Miller, D L; Bernardi, G; Rehani, M M; Schofield, P; Vañó, E; Einstein, A J; Geiger, B; Heintz, P; Padovani, R; Sim, K-H

    2013-02-01

    Cardiac nuclear medicine, cardiac computed tomography (CT), interventional cardiology procedures, and electrophysiology procedures are increasing in number and account for an important share of patient radiation exposure in medicine. Complex percutaneous coronary interventions and cardiac electrophysiology procedures are associated with high radiation doses. These procedures can result in patient skin doses that are high enough to cause radiation injury and an increased risk of cancer. Treatment of congenital heart disease in children is of particular concern. Additionally, staff(1) in cardiac catheterisation laboratories may receive high doses of radiation if radiological protection tools are not used properly. The Commission provided recommendations for radiological protection during fluoroscopically guided interventions in Publication 85, for radiological protection in CT in Publications 87 and 102, and for training in radiological protection in Publication 113 (ICRP, 2000b,c, 2007a, 2009). This report is focused specifically on cardiology, and brings together information relevant to cardiology from the Commission's published documents. There is emphasis on those imaging procedures and interventions specific to cardiology. The material and recommendations in the current document have been updated to reflect the most recent recommendations of the Commission. This report provides guidance to assist the cardiologist with justification procedures and optimisation of protection in cardiac CT studies, cardiac nuclear medicine studies, and fluoroscopically guided cardiac interventions. It includes discussions of the biological effects of radiation, principles of radiological protection, protection of staff during fluoroscopically guided interventions, radiological protection training, and establishment of a quality assurance programme for cardiac imaging and intervention. As tissue injury, principally skin injury, is a risk for fluoroscopically guided interventions

  15. Long Radiology Workdays Reduce Detection and Accommodation Accuracy

    PubMed Central

    Krupinski, Elizabeth A.; Berbaum, Kevin S.; Caldwell, Robert T.; Schartz, Kevin M.; Kim, John

    2010-01-01

    Purpose: To measure diagnostic accuracy of fracture detection, visual accommodation, reading time, and subjective ratings of fatigue and visual strain before and after a day of clinical reading. Methods: Forty attending radiologists and radiology residents viewed 60 de-identified HIPAA compliant bone examinations, half with fractures, once before any clinical reading (Early) and once after a day of clinical reading (Late). Reading time was recorded. Visual accommodation (ability to maintain focus) was measured before and after each reading session. Subjective ratings of symptoms of fatigue and oculomotor strain were collected. The study was approved by local IRBs. Results: Diagnostic accuracy was reduced significantly after a day of clinical reading, with average receiver operating characteristic (ROC) area under the curve (AUC) of 0.885 for Early reading and 0.852 for Late reading (p < 0.05). After a day of image interpretation, visual accommodation was no more variable, though error in visual accommodation was greater (p < 0.01) and subjective ratings of fatigue were higher. Conclusions: After a day of clinical reading, radiologists have reduced ability to focus, increased symptoms of fatigue and oculomotor strain, and reduced ability to detect fractures. Radiologists need to be aware of the effects of fatigue on diagnostic accuracy and take steps to mitigate these effects. PMID:20816631

  16. Development of a multiple sclerosis functional composite as a clinical trial outcome measure.

    PubMed

    Cutter, G R; Baier, M L; Rudick, R A; Cookfair, D L; Fischer, J S; Petkau, J; Syndulko, K; Weinshenker, B G; Antel, J P; Confavreux, C; Ellison, G W; Lublin, F; Miller, A E; Rao, S M; Reingold, S; Thompson, A; Willoughby, E

    1999-05-01

    The primary clinical outcome measure for evaluating multiple sclerosis in clinical trials has been Kurtzke's expanded disability status scale (EDSS). New therapies appear to favourably impact the course of multiple sclerosis and render continued use of placebo control groups more difficult. Consequently, future trials are likely to compare active treatment groups which will most probably require increased sample sizes in order to detect therapeutic efficacy. Because more responsive outcome measures will be needed for active arm comparison studies, the National Multiple Sclerosis Society's Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis appointed a Task Force that was charged with developing improved clinical outcome measures. This Task Force acquired contemporary clinical trial and historical multiple sclerosis data for meta-analyses of primary and secondary outcome assessments to provide a basis for recommending a new outcome measure. A composite measure encompassing the major clinical dimensions of arm, leg and cognitive function was identified and termed the multiple sclerosis functional composite (MSFC). The MSFC consists of three objective quantitative tests of neurological function which are easy to administer. Change in this MSFC over the first year of observation predicted subsequent change in the EDSS, suggesting that the MSFC is more sensitive to change than the EDSS. This paper provides details concerning the development and testing of the MSFC.

  17. Utilizing measure-based feedback in control-mastery theory: A clinical error.

    PubMed

    Snyder, John; Aafjes-van Doorn, Katie

    2016-09-01

    Clinical errors and ruptures are an inevitable part of clinical practice. Often times, therapists are unaware that a clinical error or rupture has occurred, leaving no space for repair, and potentially leading to patient dropout and/or less effective treatment. One way to overcome our blind spots is by frequently and systematically collecting measure-based feedback from the patient. Patient feedback measures that focus on the process of psychotherapy such as the Patient's Experience of Attunement and Responsiveness scale (PEAR) can be used in conjunction with treatment outcome measures such as the Outcome Questionnaire 45.2 (OQ-45.2) to monitor the patient's therapeutic experience and progress. The regular use of these types of measures can aid clinicians in the identification of clinical errors and the associated patient deterioration that might otherwise go unnoticed and unaddressed. The current case study describes an instance of clinical error that occurred during the 2-year treatment of a highly traumatized young woman. The clinical error was identified using measure-based feedback and subsequently understood and addressed from the theoretical standpoint of the control-mastery theory of psychotherapy. An alternative hypothetical response is also presented and explained using control-mastery theory. (PsycINFO Database Record PMID:27631857

  18. Radiological diagnosis of Brodie's abscess.

    PubMed

    Kowalewski, Michał; Swiatkowski, Jan; Michałowska, Ilona; Swiecicka, Dorota

    2002-12-30

    Background. Brodie's abscess is a kind of rare subacute or chronic osteitis. It is probably caused by mistreated or non-treated osteitis, or by bacteria of low virulence.
    Material and methods. In the Orthopedic and Traumatology Clinic of our medical school 5 patients were diagnosed with Brodie's obsecess between 1999 and 2002. all the patients had conventional x-rays, while one also had CT and MRI.
    Results and conclusions. The typical x-ray image shows an osteolytic lesion with sclerotic margin in the diametophysis. Each of the 5 patients had surgery. In 4 cases the histopatological results confirmed the radiological diagnosis. In one case fibrous dysplasia was found.

  19. Flight data recorder for interventional radiology.

    PubMed

    Duncan, James R; Street, Mandie; Fitzpatrick, Melissa; Salinas, Christian

    2012-01-01

    To test process improvement strategies, a recording system in a new pediatric interventional radiology suite was installed modeled after the flight data recorders found in modern aviation. Using the resulting data from these recordings, a variety of quality and safety improvement projects were planned including improving timeout performance and optimizing radiation use. There were several challenges, including balancing the need to protect patients during efforts to improve teamwork. However, the flight data recorder drove home the notion that interventional radiology is a team sport and that improvements can be measured by keeping score.

  20. Multiple-Time-Series Clinical Data Processing for Classification With Merging Algorithm and Statistical Measures.

    PubMed

    Tseng, Yi-Ju; Ping, Xiao-Ou; Liang, Ja-Der; Yang, Pei-Ming; Huang, Guan-Tarn; Lai, Feipei

    2015-05-01

    A description of patient conditions should consist of the changes in and combination of clinical measures. Traditional data-processing method and classification algorithms might cause clinical information to disappear and reduce prediction performance. To improve the accuracy of clinical-outcome prediction by using multiple measurements, a new multiple-time-series data-processing algorithm with period merging is proposed. Clinical data from 83 hepatocellular carcinoma (HCC) patients were used in this research. Their clinical reports from a defined period were merged using the proposed merging algorithm, and statistical measures were also calculated. After data processing, multiple measurements support vector machine (MMSVM) with radial basis function (RBF) kernels was used as a classification method to predict HCC recurrence. A multiple measurements random forest regression (MMRF) was also used as an additional evaluation/classification method. To evaluate the data-merging algorithm, the performance of prediction using processed multiple measurements was compared to prediction using single measurements. The results of recurrence prediction by MMSVM with RBF using multiple measurements and a period of 120 days (accuracy 0.771, balanced accuracy 0.603) were optimal, and their superiority to the results obtained using single measurements was statistically significant (accuracy 0.626, balanced accuracy 0.459, P < 0.01). In the cases of MMRF, the prediction results obtained after applying the proposed merging algorithm were also better than single-measurement results (P < 0.05). The results show that the performance of HCC-recurrence prediction was significantly improved when the proposed data-processing algorithm was used, and that multiple measurements could be of greater value than single.

  1. Evidence-Based Assessment for Children and Adolescents: Issues in Measurement Development and Clinical Application

    ERIC Educational Resources Information Center

    Kazdin, Alan E.

    2005-01-01

    Advances in measurement of child and adolescent social, emotional, and behavioral functioning and clinical disorders have been remarkable and remarkably reviewed in the prior articles. This commentary identifies common themes that emerge from the articles, discusses the proliferation of measures, and raises considerations regarding how one might…

  2. A Measure for the Reliability of a Rating Scale Based on Longitudinal Clinical Trial Data

    ERIC Educational Resources Information Center

    Laenen, Annouschka; Alonso, Ariel; Molenberghs, Geert

    2007-01-01

    A new measure for reliability of a rating scale is introduced, based on the classical definition of reliability, as the ratio of the true score variance and the total variance. Clinical trial data can be employed to estimate the reliability of the scale in use, whenever repeated measurements are taken. The reliability is estimated from the…

  3. Use of Telehealth for Research and Clinical Measures in Cochlear Implant Recipients: A Validation Study

    ERIC Educational Resources Information Center

    Hughes, Michelle L.; Goehring, Jenny L.; Baudhuin, Jacquelyn L.; Diaz, Gina R.; Sanford, Todd; Harpster, Roger; Valente, Daniel L.

    2012-01-01

    Purpose: The goal of this study was to compare clinical and research-based cochlear implant (CI) measures using telehealth versus traditional methods. Method: This prospective study used an ABA design (A = laboratory, B = remote site). All measures were made twice per visit for the purpose of assessing within-session variability. Twenty-nine adult…

  4. Characterization of Potential Outcome Measures for Future Clinical Trials in Fragile X Syndrome

    ERIC Educational Resources Information Center

    Berry-Kravis, Elizabeth; Sumis, Allison; Kim, Ok-Kyung; Lara, Rebecca; Wuu, Joanne

    2008-01-01

    Clinical trials targeting recently elucidated synaptic defects in fragile X syndrome (FXS) will require outcome measures capable of assessing short-term changes in cognitive functioning. Potentially useful measures for FXS were evaluated here in a test-retest setting in males and females with FXS (N = 46). Good reproducibility, determined by an…

  5. [Clinico-radiologic correlations in common neck pain].

    PubMed

    Pacciani, E; Salsano, M L; Donnetti, L; Urso, S

    1996-05-01

    Patients with spontaneous neck pain, headache, dizziness and/or pain to the upper limbs are frequently observed. Common cervicodynia, due to the involvement of arthromuscular structures of the cervical spine, was diagnosed in the patients with these symptoms in the absence of trauma or neurologic signs. The authors investigated the clinical-radiologic correlation in a series of 130 symptomatic patients and considered it a metameric disorder. The frequent association of many radiographic signs at the same level often prevents single radiographic signs from being assessed individually; therefore, the authors selected some patients with just one radiographic change per functional unit, to assess its relationship with clinical symptoms. The patients underwent anteroposterior, lateral and functional (flexion-extension) radiographs of the cervical spine. Vertebral rotation, detected on antero-posterior views as a spinous process deviation, was the most frequent isolated sign (79/130 cases) per metameric level, with strong clinical correlation (70/79 cases). Vertebral rotation was probably due to unilateral muscular stiffness. Other single radiologic signs per functional unit with strong clinical correlation follow: atloaxial rotation (13/130 with clinical-radiologic agreement of 12/13), functional blockage (13/130 with clinical-radiologic agreement of 11/13), angular flexion (21/130 with clinical-radiologic agreement of 19/21) and overall disc space thinning (12/130 with clinical-radiologic agreement of 10/12). Atloaxial rotation is represented as an asymmetry of the spaces between the odontoid and the lateral masses of the atlas; functional blockage consists of insufficient or lacking physiological width of the occipito-atlantoid or interspinous space in functional tests. Angular flexion consists of a single flexion angle of the cervical spine in functional tests; two or more angles indicate normal flexion of the cervical spine. This study confirmed the poorer clinical

  6. Emerging strategic themes for guiding change in academic radiology departments.

    PubMed

    Chan, Stephen; Gunderman, Richard B

    2005-08-01

    Academic radiologists are faced with increasing demands on their time and energy, particularly in the clinical arena, where larger examination volumes and higher service expectations are the norm for most medical centers. These demands are intensified by the continuing shortage of academic radiologists. If academic radiology departments continue to devote most of their resources to the clinical mission at the expense of research and educational missions, then there are potentially serious adverse consequences for long-term viability of the profession of radiology. This dilemma represents a critical strategic problem, not just for academic radiology but also for the entire profession of radiology. In this article, the success and growth of academic radiology during the 20th century are framed as the result of the dogged pursuit of certain key strategic themes. With the concept of paradigm shift, introduced by Kuhn, several new strategic themes are identified that are just emerging from changes in work practices, organizational structure, and mind-sets in radiology departments at academic medical centers. One benefit of this approach is that it facilitates the ability of radiologists to articulate and focus on those strategic themes that will help academic radiology departments to adapt more rapidly and successfully to environmental changes during the 21st century. PMID:15972339

  7. Internal Controlling of a Radiology Department.

    PubMed

    Frewer, W; Busch, H P

    2015-11-01

    Caused by legal reform initiatives there is a continuous need to increase effectiveness and efficiency in hospitals and surgeries, and thus to improve processes.Consequently the successful management of radiological departments and surgeries requires suitable structures and optimization processes to make optimization in the fields of medical quality, service quality and efficiency possible.In future in the DRG System it is necessary that the organisation of processes must focus on the whole clinical treatment of the patients (Clinical Pathways). Therefore the functions of controlling must be more established and adjusted. On the basis of select Controlling instruments like budgeting, performance indicators, process optimization, staff controlling and benchmarking the target-based and efficient control of radiological surgeries and departments is shown. PMID:26230139

  8. Internal Controlling of a Radiology Department.

    PubMed

    Frewer, W; Busch, H P

    2015-11-01

    Caused by legal reform initiatives there is a continuous need to increase effectiveness and efficiency in hospitals and surgeries, and thus to improve processes.Consequently the successful management of radiological departments and surgeries requires suitable structures and optimization processes to make optimization in the fields of medical quality, service quality and efficiency possible.In future in the DRG System it is necessary that the organisation of processes must focus on the whole clinical treatment of the patients (Clinical Pathways). Therefore the functions of controlling must be more established and adjusted. On the basis of select Controlling instruments like budgeting, performance indicators, process optimization, staff controlling and benchmarking the target-based and efficient control of radiological surgeries and departments is shown.

  9. Radiology of the eye and orbit

    SciTech Connect

    Newton, T.H.; Bilaniuk, L.T.

    1990-01-01

    This book reports on the use of magnetic resonance imaging, ultrasound, and computed tomography to evaluate ocular and orbital disorders. The book gives a complete understanding of the capabilities of these techniques, the normal orbital anatomy shown by each modality, and the radiologic features and clinical aspects of orbital diseases, enabling radiologists and clinicians to choose the optimum diagnostic modality and accurately interpret abnormalities seen on scans. Included are more than 900 detail-revealing scans depicting normal anatomy and pathologic finds. For each of the three imaging modalities, a clear explanation of technique is followed by chapters thoroughly describing and illustrating ocular and orbital anatomy and pathology. The chapters on pathology discuss radiologic differential diagnosis in detail and briefly describe disease entities and their clinical manifestations.

  10. Publication in radiology: challenges to tradition.

    PubMed

    Figley, M M

    1985-12-01

    Publications in radiology have become vastly proliferated and highly differentiated compared with the past. They have developed in response to several factors: accelerating scientific progress, clinical subspecialization, industrialization of practice, and growth of academic and clinical practitioners. New peer-reviewed journals, controlled periodicals heavily subsidized by advertising, newspapers, and newsletters of various forms have arisen. The command the traditional journals, Radiology and the American Journal of Roentgenology, once had upon reader attention has been challenged. But with rigorous editing, broad content, and pleasing format, these have grown with the competition to retain their positions. Electronic publishing is another challenge they face and which they have begun to incorporate in their production. At this point, it appears the printed page will survive and that the traditional journals will continue to serve our specialty along with newcomers for which there are more specialized roles.

  11. New clinical end points in rehabilitation medicine: tools for measuring quality of life.

    PubMed

    Abresch, Richard T; Carter, Gregory T; Han, Jay J; McDonald, Craig M

    Traditional clinical end points in rehabilitation medicine have centered on objective measures of human performance, including quantitative muscle strength testing, functional independence measurements (FIM), and timed motor performance (TMP). However, it is now increasingly recognized that health-related quality of life (HRQoL) is a valid clinical end point. Health-related quality of life is a broad concept involving an individual's physical health, psychological state, personal beliefs, and interpersonal and social support relationships. The goals for this article are to show the value of performing HRQoL measurements and briefly describe methods used to assess quality of life (QoL). PMID:19923631

  12. INTEGRATING CLINICAL LABORATORY MEASURES AND ICD-9 CODE DIAGNOSES IN PHENOME-WIDE ASSOCIATION STUDIES

    PubMed Central

    Verma, Anurag; Leader, Joseph B.; Verma, Shefali S.; Frase, Alex; Wallace, John; Dudek, Scott; Lavage, Daniel R.; Van Hout, Cristopher V.; Dewey, Frederick E.; Penn, John; Lopez, Alex; Overton, John D.; Carey, David J.; Ledbetter, David H.; Kirchner, H. Lester; Ritchie, Marylyn D.; Pendergrass, Sarah A.

    2016-01-01

    Electronic health records (EHR) provide a comprehensive resource for discovery, allowing unprecedented exploration of the impact of genetic architecture on health and disease. The data of EHRs also allow for exploration of the complex interactions between health measures across health and disease. The discoveries arising from EHR based research provide important information for the identification of genetic variation for clinical decision-making. Due to the breadth of information collected within the EHR, a challenge for discovery using EHR based data is the development of high-throughput tools that expose important areas of further research, from genetic variants to phenotypes. Phenome-Wide Association studies (PheWAS) provide a way to explore the association between genetic variants and comprehensive phenotypic measurements, generating new hypotheses and also exposing the complex relationships between genetic architecture and outcomes, including pleiotropy. EHR based PheWAS have mainly evaluated associations with case/control status from International Classification of Disease, Ninth Edition (ICD-9) codes. While these studies have highlighted discovery through PheWAS, the rich resource of clinical lab measures collected within the EHR can be better utilized for high-throughput PheWAS analyses and discovery. To better use these resources and enrich PheWAS association results we have developed a sound methodology for extracting a wide range of clinical lab measures from EHR data. We have extracted a first set of 21 clinical lab measures from the de-identified EHR of participants of the Geisinger MyCode™ biorepository, and calculated the median of these lab measures for 12,039 subjects. Next we evaluated the association between these 21 clinical lab median values and 635,525 genetic variants, performing a genome-wide association study (GWAS) for each of 21 clinical lab measures. We then calculated the association between SNPs from these GWAS passing our Bonferroni

  13. Early changes in bone mineral density measured by digital X-ray radiogrammetry predict up to 20 years radiological outcome in rheumatoid arthritis

    PubMed Central

    2011-01-01

    Introduction Changes in bone mineral density (BMD) in the hand as evaluated by digital X-ray radiogrammetry (DXR) of the second to fourth metacarpal bones has been suggested to predict future joint damage in patients with rheumatoid arthritis (RA). This study's objective was to investigate whether DXR-BMD loss early in the course of the disease predicts the development of joint damage in RA patients followed for up to 20 years. Methods A total of 183 patients (115 women and 68 men) with early RA (mean disease duration, 11 months) included from 1985 to 1989 were followed prospectively (the Lund early RA cohort). Clinical and functional measures were assessed yearly. Joint damage was evaluated according to the Larsen score on radiographs of the hands and feet obtained in years 0 to 5 and years 10, 15 and 20. These radiographs were digitized, and BMD of the second to fourth metacarpal bones was evaluated by DXR. Early DXR-BMD change rate (that is, bone loss) per year calculated from the first two radiographs obtained on average 9 months apart (SD ± 4.8) were available for 135 patients. Mean values of the right and left hand were used. Results Mean early DXR-BMD loss during the first year calculated was -0.023 g/cm2 (SD ± 0.025). Patients with marked bone loss, that is, early DXR-BMD loss above the median for the group, had significantly worse progression of joint damage at all examinations during the 20-year period. Conclusions Early DXR-BMD progression rate predicted the development of joint damage evaluated according to Larsen score at year 1 and for up to 20 years in this cohort of early RA patients. PMID:21345204

  14. Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria

    PubMed Central

    2011-01-01

    Background Conservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients. Methods The analysis comprised separately: (1) single structural thoracic, thoracolumbar or lumbar curves and (2) double structural scoliosis-thoracic and thoracolumbar or lumbar curves. The Cobb angle and Risser sign were analyzed at the initial stage and at the 2.8-year follow-up. The percentage of patients improved (defined as decrease of Cobb angle of more than 5 degrees), stable (+/- 5 degrees), and progressed (increase of Cobb angle of more than 5 degrees) was calculated. The clinical assessment comprised: the Angle of Trunk Rotation (ATR) initial and follow-up value, the plumb line imbalance, the scapulae level and the distance from the apical spinous process of the primary curve to the plumb line. Results In the Group A: (1) in single structural scoliosis 50,0% of patients improved, 46,2% were stable and 3,8% progressed, while (2) in double scoliosis 50,0% of patients improved, 30,8% were stable and 19,2% progressed. In the Group B: (1) in single scoliosis 20,0% of patients improved, 80,0% were stable, no patient progressed, while (2) in double scoliosis 28,1% of patients improved, 46,9% were stable and 25,0% progressed. Conclusion Best results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish. PMID:22122964

  15. Measuring physicians' performance in clinical practice: reliability, classification accuracy, and validity.

    PubMed

    Weifeng Weng; Hess, Brian J; Lynn, Lorna A; Holmboe, Eric S; Lipner, Rebecca S

    2010-09-01

    Much research has been devoted to addressing challenges in achieving reliable assessments of physicians' clinical performance but less work has focused on whether valid and accurate classification decisions are feasible. This study used 957 physicians certified in internal medicine (IM) or a subspecialty, who completed the American Board of Internal Medicine (ABIM) Diabetes Practice Improvement Module (PIM). Ten clinical and two patient-experience measures were aggregated into a composite measure. The composite measure score was highly reliable (r = .91) and classification accuracy was high across the entire score scale (>0.90), which indicated that it is possible to differentiate high-performing and low-performing physicians. Physicians certified in endocrinology and those who scored higher on their IM certification examination had higher composite scores, providing some validity evidence. In summary, it is feasible to create a psychometrically robust composite measure of physicians' clinical performance, specifically for the quality of care they provide to patients with diabetes.

  16. Delivering radiology supplies just-in-time.

    PubMed

    Clinton, M

    1999-01-01

    The radiology department at Dartmouth Hitchcock Medical Center (DHMC) adopted a just-in-time (JIT) inventory management system in 1992, reducing the volume of its in-house inventory of radiology supplies from a value of $400,000 to $16,000, just enough for four to five days of activity. An asset manager, the only person authorized to order supplies, was given responsibility for maintaining the department's supply of fixed and consumable assets. The first step in implementing the new system was to identify the supplies needed, standardize them and determine how often deliveries would be made. The JIT implementation team developed a request for proposal (RFP) that incorporated the standardized list of supplies. Three radiology supply vendors were invited to respond to the RFP. The team later determined that only one vendor was capable of implementing the JIT program. A three-year contract was awarded to that vendor. As that three-year contract reached completion, DHMC offered the JIT program to its eight affiliate hospitals and four outpatient clinics. The team decided to re-bid the contract for the entire network, which collectively performed 700,000 radiology exams annually. The new RFP encompassed 90 percent of the network's consumable supplies and offered customized delivery for each facility. The team identified eight criteria necessary for the evaluation of each vendor response to the RFP, rather than use price as the only consideration. The company that won the three-year contract furnished 90 percent of the radiology supplies for the DHMC network, allowing even further savings by the network, particularly for the smaller facilities and clinics. The program is continually monitored, adjusted and enhanced in order to incorporate changing departmental needs. PMID:10539360

  17. Assessing mental imagery in clinical psychology: a review of imagery measures and a guiding framework.

    PubMed

    Pearson, David G; Deeprose, Catherine; Wallace-Hadrill, Sophie M A; Burnett Heyes, Stephanie; Holmes, Emily A

    2013-02-01

    Mental imagery is an under-explored field in clinical psychology research but presents a topic of potential interest and relevance across many clinical disorders, including social phobia, schizophrenia, depression, and post-traumatic stress disorder. There is currently a lack of a guiding framework from which clinicians may select the domains or associated measures most likely to be of appropriate use in mental imagery research. We adopt an interdisciplinary approach and present a review of studies across experimental psychology and clinical psychology in order to highlight the key domains and measures most likely to be of relevance. This includes a consideration of methods for experimentally assessing the generation, maintenance, inspection and transformation of mental images; as well as subjective measures of characteristics such as image vividness and clarity. We present a guiding framework in which we propose that cognitive, subjective and clinical aspects of imagery should be explored in future research. The guiding framework aims to assist researchers in the selection of measures for assessing those aspects of mental imagery that are of most relevance to clinical psychology. We propose that a greater understanding of the role of mental imagery in clinical disorders will help drive forward advances in both theory and treatment.

  18. Assessing mental imagery in clinical psychology: A review of imagery measures and a guiding framework

    PubMed Central

    Pearson, David G.; Deeprose, Catherine; Wallace-Hadrill, Sophie M.A.; Heyes, Stephanie Burnett; Holmes, Emily A.

    2013-01-01

    Mental imagery is an under-explored field in clinical psychology research but presents a topic of potential interest and relevance across many clinical disorders, including social phobia, schizophrenia, depression, and post-traumatic stress disorder. There is currently a lack of a guiding framework from which clinicians may select the domains or associated measures most likely to be of appropriate use in mental imagery research. We adopt an interdisciplinary approach and present a review of studies across experimental psychology and clinical psychology in order to highlight the key domains and measures most likely to be of relevance. This includes a consideration of methods for experimentally assessing the generation, maintenance, inspection and transformation of mental images; as well as subjective measures of characteristics such as image vividness and clarity. We present a guiding framework in which we propose that cognitive, subjective and clinical aspects of imagery should be explored in future research. The guiding framework aims to assist researchers in the selection of measures for assessing those aspects of mental imagery that are of most relevance to clinical psychology. We propose that a greater understanding of the role of mental imagery in clinical disorders will help drive forward advances in both theory and treatment. PMID:23123567

  19. Evaluation of critical pathways, radionuclides, and remedial measures for reducing the radiological dose to returning populations at a former nuclear test site

    SciTech Connect

    Robison, W. L., LLNL

    1997-11-01

    Bikini Island, the major residence island at Bikini Atoll, was contaminated with radioactive fallout as a result of the BRAVO test conducted on March 1, 1954. We have identified the critical radionuclides and supplied radiological data needed to develop dose estimates for all possible exposure pathways. These estimates show that the major dose to returning populations would result from ingestion of cesium-137 (137 Cs) in locally grown terrestrial foods where the predicted population average effective dose exceeds current federal guidelines. Consequently, we designed several long-term field experiments to develop and evaluate methods to reduce the 137 Cs content in locally grown foods.This paper gives a general outline of the remediation experiments with a more detailed description of a preferred combined option. Our comparative evaluation on various remedial methods show that the combined option--potassium treatment of the entire islands with limited excavation of soil in village an d housing areas--will be effective in reducing the dose to about 10% of pretreatment levels, and offers very significant benefits with respect to adverse environmental impacts as well as savings in overall costs, time, and required expert resources.

  20. Comparison of air kerma measurements between the PTB and the IAEA for x-radiation qualities used in general diagnostic radiology and mammography

    NASA Astrophysics Data System (ADS)

    Csete, István; Büermann, Ludwig; Gomola, Igor; Girzikowsky, Reinhard

    2013-01-01

    A comparison of the air kerma standards for x-radiation qualities used in general diagnostic radiology and mammography, identified as EURAMET.RI(I)-S10 (EURAMET project #1221), was performed between the PTB and the IAEA. Two spherical and two parallel-plate reference-class ionization chambers of the IAEA and 12 beam qualities standardized in the IEC standard 61267:2005 plus 7 additional standard beam qualities established at both laboratories were selected for the comparison. The calibration coefficients were determined for the transfer chambers at the PTB in September 2012 and before and after this at the IAEA Dosimetry Laboratory. The results show the calibration coefficients of both laboratories to be in good agreement within the standard uncertainty of the comparison of about 0.47%. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by EURAMET, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  1. Pediatric urologic radiology. Intervention and endourology

    SciTech Connect

    Mandell, V.S.; Mandell, J.; Gaisie, G.

    1985-02-01

    Over the past 10 years new imaging and interventional techniques have drastically changed the ease and scope of urologic diagnosis and treatment. It is both rewarding and exciting to approach each clinical problem with a broad armamentarium of available studies, always seeking the most efficient and direct route to diagnosis. Similarly, radiologic interventional techniques are potentially applicable to a multitude of problems and should be innovatively considered in the urologic patient including patients in the pediatric age group.

  2. Clinical complexity in medicine: A measurement model of task and patient complexity

    PubMed Central

    Islam, R.; Weir, C.; Fiol, G. Del

    2016-01-01

    Summary Background Complexity in medicine needs to be reduced to simple components in a way that is comprehensible to researchers and clinicians. Few studies in the current literature propose a measurement model that addresses both task and patient complexity in medicine. Objective The objective of this paper is to develop an integrated approach to understand and measure clinical complexity by incorporating both task and patient complexity components focusing on infectious disease domain. The measurement model was adapted and modified to healthcare domain. Methods Three clinical Infectious Disease teams were observed, audio-recorded and transcribed. Each team included an Infectious Diseases expert, one Infectious Diseases fellow, one physician assistant and one pharmacy resident fellow. The transcripts were parsed and the authors independently coded complexity attributes. This baseline measurement model of clinical complexity was modified in an initial set of coding process and further validated in a consensus-based iterative process that included several meetings and email discussions by three clinical experts from diverse backgrounds from the Department of Biomedical Informatics at the University of Utah. Inter-rater reliability was calculated using Cohen’s kappa. Results The proposed clinical complexity model consists of two separate components. The first is a clinical task complexity model with 13 clinical complexity-contributing factors and 7 dimensions. The second is the patient complexity model with 11 complexity-contributing factors and 5 dimensions. Conclusion The measurement model for complexity encompassing both task and patient complexity will be a valuable resource for future researchers and industry to measure and understand complexity in healthcare. PMID:26404626

  3. Meeting the 2012 QIP (Quality Incentive Program) clinical measures: strategies for dialysis centers.

    PubMed

    Fishbane, Steven; Hazzan, Azzour

    2012-11-01

    The US Centers for Medicare & Medicaid Services end-stage renal disease Quality Incentive Program (QIP) is a pay-for-performance program that reduces dialysis center payments by up to 2% for suboptimal patient care. In January 2012, the performance year began for payment year 2014, bringing significant changes to the QIP by introducing 6 quality indicators (3 clinical measures and 3 reporting measures) and a new scoring methodology. To succeed under the new QIP, dialysis facilities must meet 3 clinical measures that assess anemia management, hemodialysis adequacy, and vascular access type in patients receiving dialysis treatment, as well as 3 reporting measures that involve the reporting of dialysis safety events, attestation of administering a patient satisfaction survey, and attestation of patient mineral metabolism monitoring. To help dialysis providers reach these targets, this article provides an overview of the 3 clinical measures and the QIP scoring methodology, as well as a description of patient claims that are excluded when the scores for these measures are calculated. Strategies and solutions that address provider- and patient-related factors also are discussed to help ensure that more dialysis centers meet the new QIP clinical measures for performance year 2012/payment year 2014. PMID:23063058

  4. Point-Connecting Measurements of the Hallux Valgus Deformity: A New Measurement and Its Clinical Application

    PubMed Central

    Seo, Jeong-Ho; Boedijono, Dimas

    2016-01-01

    Purpose The aim of this study was to investigate new point-connecting measurements for the hallux valgus angle (HVA) and the first intermetatarsal angle (IMA), which can reflect the degree of subluxation of the first metatarsophalangeal joint (MTPJ). Also, this study attempted to compare the validity of midline measurements and the new point-connecting measurements for the determination of HVA and IMA values. Materials and Methods Sixty feet of hallux valgus patients who underwent surgery between 2007 and 2011 were classified in terms of the severity of HVA, congruency of the first MTPJ, and type of chevron metatarsal osteotomy. On weight-bearing dorsal-plantar radiographs, HVA and IMA values were measured and compared preoperatively and postoperatively using both the conventional and new methods. Results Compared with midline measurements, point-connecting measurements showed higher inter- and intra-observer reliability for preoperative HVA/IMA and similar or higher inter- and intra-observer reliability for postoperative HVA/IMA. Patients who underwent distal chevron metatarsal osteotomy (DCMO) had higher intraclass correlation coefficient for inter- and intra-observer reliability for pre- and post-operative HVA and IMA measured by the point-connecting method compared with the midline method. All differences in the preoperative HVAs and IMAs determined by both the midline method and point-connecting methods were significant between the deviated group and subluxated groups (p=0.001). Conclusion The point-connecting method for measuring HVA and IMA in the subluxated first MTPJ may better reflect the severity of a HV deformity with higher reliability than the midline method, and is more useful in patients with DCMO than in patients with proximal chevron metatarsal osteotomy. PMID:26996576

  5. Developing clinically suitable measures of social cognition for children: initial findings from a normative sample.

    PubMed

    Saltzman-Benaiah, Jennifer; Lalonde, Christopher E

    2007-03-01

    Our understanding of children's social competence has increased tremendously over the past two decades. There is increasing evidence to suggest that social-cognitive impairments are not restricted to children on the autistic spectrum, but rather may be associated with a host of developmental and acquired neurological conditions including learning disabilities, attention deficit disorder, traumatic brain injury, and stroke. Although many investigators have begun to bridge the gap between clinical practice and research by applying experimental tasks to clinical populations, few tools are available for the clinical evaluation of social competence, particularly in children. This study marks a series of first steps in the development of measures suitable for the assessment of children between 6 and 12 years of age. The results of the study provide data for a number of experimental tasks that have been adapted with clinical practice in mind. A discussion of the developmental progressions and the relationships among the measures is also included.

  6. Data mining in radiology.

    PubMed

    Kharat, Amit T; Singh, Amarjit; Kulkarni, Vilas M; Shah, Digish

    2014-04-01

    Data mining facilitates the study of radiology data in various dimensions. It converts large patient image and text datasets into useful information that helps in improving patient care and provides informative reports. Data mining technology analyzes data within the Radiology Information System and Hospital Information System using specialized software which assesses relationships and agreement in available information. By using similar data analysis tools, radiologists can make informed decisions and predict the future outcome of a particular imaging finding. Data, information and knowledge are the components of data mining. Classes, Clusters, Associations, Sequential patterns, Classification, Prediction and Decision tree are the various types of data mining. Data mining has the potential to make delivery of health care affordable and ensure that the best imaging practices are followed. It is a tool for academic research. Data mining is considered to be ethically neutral, however concerns regarding privacy and legality exists which need to be addressed to ensure success of data mining. PMID:25024513

  7. Data mining in radiology

    PubMed Central

    Kharat, Amit T; Singh, Amarjit; Kulkarni, Vilas M; Shah, Digish

    2014-01-01

    Data mining facilitates the study of radiology data in various dimensions. It converts large patient image and text datasets into useful information that helps in improving patient care and provides informative reports. Data mining technology analyzes data within the Radiology Information System and Hospital Information System using specialized software which assesses relationships and agreement in available information. By using similar data analysis tools, radiologists can make informed decisions and predict the future outcome of a particular imaging finding. Data, information and knowledge are the components of data mining. Classes, Clusters, Associations, Sequential patterns, Classification, Prediction and Decision tree are the various types of data mining. Data mining has the potential to make delivery of health care affordable and ensure that the best imaging practices are followed. It is a tool for academic research. Data mining is considered to be ethically neutral, however concerns regarding privacy and legality exists which need to be addressed to ensure success of data mining. PMID:25024513

  8. [Emphysematous pyelonephritis: radiologic diagnosis].

    PubMed

    Kably, M I; Elamraoui, F; Chikhaoui, N

    2003-10-01

    Emphysematous pyelonephritis (EPN) is a rare and severe form of acute pyelonephritis. Escherichia coli accounts for 60% of the cases. Predisposing factors are: diabetus mellitus, recent urinary tract infection and obstruction. There is a female predominance (2/1). Conventional radiography reveals the renal emphysema in 85% of the cases. Ultrasonography shows hyperechoic areas corresponding to the gaz. CT scan is the best technique, allowing the exact localization of the gaz inside the renal parenchyma. The natural course of the disease allows its radiologic classification in 4 grades. EPN has a poor prognosis if only a medical treatment is initiated. Every urinary tract infection, in a diabetic patient must be treated, and must lead to a radiologic exploration, which allows an early detection of severe forms of the disease. PMID:14606307

  9. Data mining in radiology.

    PubMed

    Kharat, Amit T; Singh, Amarjit; Kulkarni, Vilas M; Shah, Digish

    2014-04-01

    Data mining facilitates the study of radiology data in various dimensions. It converts large patient image and text datasets into useful information that helps in improving patient care and provides informative reports. Data mining technology analyzes data within the Radiology Information System and Hospital Information System using specialized software which assesses relationships and agreement in available information. By using similar data analysis tools, radiologists can make informed decisions and predict the future outcome of a particular imaging finding. Data, information and knowledge are the components of data mining. Classes, Clusters, Associations, Sequential patterns, Classification, Prediction and Decision tree are the various types of data mining. Data mining has the potential to make delivery of health care affordable and ensure that the best imaging practices are followed. It is a tool for academic research. Data mining is considered to be ethically neutral, however concerns regarding privacy and legality exists which need to be addressed to ensure success of data mining.

  10. Initial experiences in radiology e-learning.

    PubMed

    Sparacia, Gianvincenzo; Cannizzaro, Floreana; D'Alessandro, Donna M; D'Alessandro, Michael P; Caruso, Giuseppe; Lagalla, Roberto

    2007-01-01

    The use of two different educator-centric learning management systems (LMSs), Moodle and Manila, for radiology e-learning was formatively evaluated and the implications of the future use of LMSs in radiology education were explored. NeuroRAD, a neuroradiologic digital library and learning community, is implemented with Moodle, one of the most popular open-source educator-centric LMSs. Pediatric-Education.org, a pediatric digital library and learning community, is implemented with Manila, a commercial educator-centric LMS. Quantitative and qualitative analyses of these LMSs were performed with World Wide Web server log file statistical programs and user-submitted comment forms. In 2005, NeuroRAD was used by 9959 visitors, who read 98,495 pages of information, whereas PediatricEducation .org was used by 91,000 visitors, who read 186,000 pages of information. Visitors represented a wide spectrum of medical learners and used the sites to answer clinical questions; to prepare for lectures, conferences, and informal teaching sessions; and to stay up-to-date and prepare for examinations. Early results indicate that radiology learning communities can be implemented with educator-centric LMSs relatively easily and at low cost by radiologists with minimal computer expertise, and can find receptive and appreciative audiences. Online radiology learning communities could play a significant role in providing education to radiologists the world over throughout their careers. PMID:17374871

  11. Demystifying radiology information systems.

    PubMed

    Swearingen, R

    2000-01-01

    Selecting the right radiology information system (RIS) can be a difficult and tedious task for radiology managers. Sometimes the information systems department ends up selecting the RIS. As a radiology manager, you can help yourself and your department greatly by becoming more educated concerning the technology and terminology of radiology information systems. You can then participate in one of the most important decisions that will ever be made regarding your department. There is much confusion about the meanings of the terms interfaced and integrated. Two applications are generally considered integrated if they freely access and update each other's databases. Two applications are generally considered interfaced if they pass data to each other but don't directly access nor update the other's databases. Two more terms are centralized and decentralized. Centralized is the concept of "putting all of your eggs in one basket." Decentralization means you spread your resources out. The main difference between centralized and decentralized is that all components of a centralized system share the same fate (good or bad), while decentralized components operate independently and aren't affected directly by failures in another system. Another significant term relevant to RIS systems is HL7, which is a standardized data format that allows one application to pass data to another application in a format that the receiving application understands. RIS vendors generally fall in three categories: single-source vendors, multiproduct vendors and single-product vendors. Single-product vendors include best-of-breed vendors. No one approach is necessarily better than the others; which you choose will depend on your needs. When considering the purchase of an RIS system, there are important questions to ask yourself, the vendor and the vendors' customers as you gather information and prepare to make a decision.

  12. Disabling Radiological Dispersal Terror

    SciTech Connect

    Hart, M

    2002-11-08

    Terror resulting from the use of a radiological dispersal device (RDD) relies upon an individual's lack of knowledge and understanding regarding its significance. Disabling this terror will depend upon realistic reviews of the current conservative radiation protection regulatory standards. It will also depend upon individuals being able to make their own informed decisions merging perceived risks with reality. Preparation in these areas will reduce the effectiveness of the RDD and may even reduce the possibility of its use.

  13. Models for the analysis of repeated continuous outcome measures in clinical trials.

    PubMed

    De Livera, Alysha M; Zaloumis, Sophie; Simpson, Julie A

    2014-02-01

    Repeated continuous outcome measures are common in clinical trials. In this tutorial style paper, using data collected from a trial evaluating an intervention for managing asthma and chronic obstructive pulmonary disease, we demonstrate ways of statistically analysing such data to answer frequently encountered clinical research questions. We illustrate the use of linear mixed effects modelling in doing so and discuss its advantages over several other commonly used approaches. The methods described in this paper can easily be carried out using standard statistical software.

  14. Radiological image presentation requires consideration of human adaptation characteristics

    NASA Astrophysics Data System (ADS)

    O'Connell, N. M.; Toomey, R. J.; McEntee, M.; Ryan, J.; Stowe, J.; Adams, A.; Brennan, P. C.

    2008-03-01

    Visualisation of anatomical or pathological image data is highly dependent on the eye's ability to discriminate between image brightnesses and this is best achieved when these data are presented to the viewer at luminance levels to which the eye is adapted. Current ambient light recommendations are often linked to overall monitor luminance but this relies on specific regions of interest matching overall monitor brightness. The current work investigates the luminances of specific regions of interest within three image-types: postero-anterior (PA) chest; PA wrist; computerised tomography (CT) of the head. Luminance levels were measured within the hilar region and peripheral lung distal radius and supra-ventricular grey matter. For each image type average monitor luminances were calculated with a calibrated photometer at ambient light levels of 0, 100 and 400 lux. Thirty samples of each image-type were employed, resulting in a total of over 6,000 measurements. Results demonstrate that average monitor luminances varied from clinically-significant values by up to a factor of 4, 2 and 6 for chest, wrist and CT head images respectively. Values for the thoracic hilum and wrist were higher and for the peripheral lung and CT brain lower than overall monitor levels. The ambient light level had no impact on the results. The results demonstrate that clinically important radiological information for common radiological examinations is not being presented to the viewer in a way that facilitates optimised visual adaptation and subsequent interpretation. The importance of image-processing algorithms focussing on clinically-significant anatomical regions instead of radiographic projections is highlighted.

  15. Facilitating comfort for hospitalized patients using non-pharmacological measures: preliminary development of clinical practice guidelines.

    PubMed

    Williams, Anne M; Davies, Anne; Griffiths, Gareth

    2009-06-01

    Nurses often use non-pharmacological measures to facilitate comfort for patients within the hospital setting. However, guidelines for use of these measures are commonly inadequate or absent. This paper presents 12 clinical practice guidelines that were developed from the findings of a literature review into non-pharmacological measures that are thought to facilitate patient comfort. The non-pharmacological measures addressed in these guidelines are: Aromotherapy, Distraction, Guided Imagery, Laughter, Massage, Music, Reiki, Heat or Cold, Meditation, Reflexology, Reposition and Transcutaneous Electrical Nerve Stimulation. These are preliminary guidelines for the use of non-pharmacological measures and further research and development of such guidelines is recommended.

  16. Validity of symptom and clinical measures of asthma severity for primary outpatient assessment of adult asthma.

    PubMed Central

    Ng, T P

    2000-01-01

    BACKGROUND: Symptom and pulmonary function measures of asthma severity are used for severity classification in practice guidelines. However, there is limited methodological evidence in support of their validity and utility. AIM: To validate initial symptom and forced expiratory volume (FEV1) measures of asthma severity with the subsequent risks of exacerbations resulting in emergency room (ER) visits, hospitalisation, and sickness absence from work. In addition, symptom-based measures of change in asthma severity were also evaluated against the concurrent risks of asthma exacerbations. METHOD: A cohort of 361 adult asthmatic patients in general outpatient clinics was studied. At initial interview, frequencies of asthmatic symptoms and nocturnal exacerbations, FEV1, and a severity score combining these measures, were recorded. At re-interview in the third year, the frequencies of asthma exacerbations resulting in ER visits, hospitalisation, and sickness absence, and a self-assessed global measure of change in severity and serially-assessed change in symptom frequencies, were measured. RESULTS: All individual symptom and FEV1 measures were strongly related to the subsequent risks of ER visits, hospitalisation, and sick absence. A severity score of more than 3 (moderate to severe asthma) and self-assessed change in asthma severity were most strongly and significantly associated with greatly increased risks of all outcomes. Individual symptoms and FEV1 measures alone did not show high sensitivities, but the severity score combining these measures gave much more satisfactory validity. Perhaps not surprisingly, self-assessed change in asthma appeared to give the most satisfactory validity. CONCLUSION: These results support the validity and clinical utility of a simple clinical score based on symptom and FEV1 measures, and self-assessed measure of change in severity, for risk classification in contemporary clinical practice guidelines. PMID:10695059

  17. Measurement equivalence of the Toronto Structured Interview for Alexithymia across language, gender, and clinical status.

    PubMed

    Keefer, Kateryna V; Taylor, Graeme J; Parker, James D A; Inslegers, Ruth; Michael Bagby, R

    2015-08-30

    The Toronto Structured Interview for Alexithymia (TSIA) has been translated into Dutch, German, and Italian and validated in clinical and nonclinical populations. In order to make valid comparisons across different population groups, it is important to establish measurement equivalence across variables such as language, gender, and clinical status. Our objective in this study was to establish measurement equivalence in relation to language (English, Dutch, German, and Italian), gender, and clinical status (non-clinical, psychiatric, and medical) using differential item functioning (DIF). The sample was composed of 842 adults representing the four language groups, all of whom had undergone the TSIA assessment as part of several earlier studies. Ordinal Logistic Regression was employed to explore DIF of the TSIA items. Although several items were found to exhibit DIF for language, gender, or clinical status, all of these effects were within an acceptable range. These findings provide support for the measurement equivalence of the TSIA, and allow researchers to reliably compare results from studies using the TSIA across the four language groups, gender, and clinical status.

  18. Integrating Radiology and Anatomy Teaching in Medical Education in the UK--The Evidence, Current Trends, and Future Scope.

    PubMed

    Heptonstall, N B; Ali, T; Mankad, K

    2016-04-01

    This review article presents the current evidence of the importance of integrating radiology and anatomy in medical education in the UK, a recommendation by a number of key anatomy, education, and radiology organizations. Current evidence highlights that on average only 5% of total teaching time in medical education is dedicated to radiology. Often, radiology teaching does not adequately fulfill students' learning needs and potentially leaves them underprepared for medical practice. Benefits of integrating radiology and anatomy include improved clinical application of anatomy, an increase in student's interest in anatomy, and ultimately improved radiological interpretation. Various modalities exist for the integration of radiology and anatomy, facilitated by the vast portability of radiological images. It appears that combining radiological resources with traditional anatomy teaching methodology in a blended approach is most beneficial. PMID:26970390

  19. Critical dosimetry measures and surrogate tools that can facilitate clinical success in PDT (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Pogue, Brian W.; Davis, Scott C.; Kanick, Stephen C.; Maytin, Edward V.; Pereira, Stephen P.; Palanisami, Akilan; Hasan, Tayyaba

    2016-03-01

    Photodynamic therapy can be a highly complex treatment with more than one parameter to control, or in some cases it is easily implemented with little control other than prescribed drug and light values. The role of measured dosimetry as related to clinical adoption has not been as successful as it could have been, and part of this may be from the conflicting goals of advocating for as many measurements as possible for accurate control, versus companies and clinical adopters advocating for as few measurements as possible, to keep it simple. An organized approach to dosimetry selection is required, which shifts from mechanistic measurements in pre-clinical and early phase I trials, towards just those essential dose limiting measurements and a focus on possible surrogate measures in phase II/III trials. This essential and surrogate approach to dosimetry should help successful adoption of clinical PDT if successful. The examples of essential dosimetry points and surrogate dosimetry tools which might be implemented in phase II and higher trials are discussed for solid tissue PDT with verteporfin and skin lesion treatment with aminolevulinc acid.

  20. New standard measures for clinical voice analysis include high speed films

    NASA Astrophysics Data System (ADS)

    Pedersen, Mette; Munch, Kasper

    2012-02-01

    In the clinical work with patients in a medical voice clinic it is important to have a normal updated reference for the data used. Several new parameters have to be correlated to older traditional measures. The older ones are stroboscopy, eventually coordinated with electroglottography (EGG), the Multi- Dimensional-Voice Program and airflow rates. Long Time Averaged Spectrograms (LTAS) and phonetograms (voice profiles) are calculating the range and dynamics of tones of the patients. High-speed films, updated airflow measures as well as area calculations of phonotograms add information to the understanding of the glottis closure in single movements of the vocal cords. A multivariate analysis was made to study the connection between the measures. This information can be used in many connections, also in the otolaryngological clinic.