RESUMEN
This study determines the reproducibility of magnetic resonance elastography (MRE) derived brain stiffness in normal volunteers and compares it against pseudotumor patients before and after lumbar puncture (LP). MRE was performed on 10 normal volunteers for reproducibility and 14 pseudotumor patients before and after LP. During LP, opening and closing cerebrospinal fluid (CSF) pressures were recorded before and after removal of CSF and correlated to brain stiffness. Stiffness reproducibility was observed (râ¯>â¯0.78; pâ¯<â¯0.008). Whole brain opening LP stiffness was significantly (pâ¯=â¯0.04) higher than normals, but no significant difference (pâ¯=â¯0.11) in closing LP measurements. No significant correlation was observed between opening and closing pressure and brain stiffness.
Asunto(s)
Encéfalo/diagnóstico por imagen , Presión Intracraneal/fisiología , Imagen por Resonancia Magnética/métodos , Seudotumor Cerebral/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino , Seudotumor Cerebral/fisiopatología , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Adulto JovenAsunto(s)
Traumatismos Abdominales/diagnóstico por imagen , Intestinos/diagnóstico por imagen , Intestinos/lesiones , Heridas no Penetrantes/diagnóstico por imagen , Abdomen/diagnóstico por imagen , Pared Abdominal/diagnóstico por imagen , Adulto , Anciano , Femenino , Humanos , Masculino , Mesenterio/diagnóstico por imagen , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
Computed tomography (CT) scanning is an essential diagnostic tool and has revolutionized care of patients in the acute care setting. However, there is widespread agreement that overutilization of CT, where benefits do not exceed possible costs or harms, is occurring. The goal was to seek consensus in identifying and prioritizing research questions and themes that involve the comparative effectiveness of "traditional" CT use versus alternative diagnostic strategies in the acute care setting. A modified Delphi technique was used that included input from emergency physicians, emergency radiologists, medical physicists, and an industry expert to achieve this.
Asunto(s)
Investigación sobre la Eficacia Comparativa/organización & administración , Servicio de Urgencia en Hospital/organización & administración , Investigación sobre Servicios de Salud/organización & administración , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Conferencias de Consenso como Asunto , Análisis Costo-Beneficio , Técnica Delphi , Medicina de Emergencia , Humanos , Tomografía Computarizada por Rayos X/normasRESUMEN
OBJECTIVE: Acute and emergent genitourinary conditions require accurate and rapid diagnosis to minimize patient morbidity and mortality. CONCLUSION: Radiologists' familiarity with the various conditions of the urinary system and of the male and female reproductive organs is important given the widespread use of imaging for the diagnosis of common clinical entities presenting to the emergency department.
Asunto(s)
Cuidados Críticos/métodos , Servicios Médicos de Urgencia/métodos , Enfermedades Urogenitales Femeninas/diagnóstico , Imagen por Resonancia Magnética/métodos , Enfermedades Urogenitales Masculinas/diagnóstico , Tomografía Computarizada por Rayos X/métodos , Adulto , Diagnóstico Diferencial , Femenino , Enfermedades Urogenitales Femeninas/terapia , Humanos , Masculino , Enfermedades Urogenitales Masculinas/terapia , Persona de Mediana Edad , Adulto JovenRESUMEN
Early intervention and prevention of hospitalizations would reduce the burden of heart failure on the healthcare system while improving the quality of life of affected patients. Traditional methods of patient assessment, including physical examination and patient report of symptoms, have a low sensitivity for detecting elevations in left ventricular filling pressure, a major precursor of pulmonary congestion and heart failure decompensation. Intrathoracic fluid accumulation during pulmonary congestion leads to decreased impedance across the lung. The OptiVol system in the InSync Sentrycardiac resynchronization therapy-defibrillator, Concerto cardiac resynchronization therapy-defibrillator and Virtuoso implantable cardioverter-defibrillator devices monitors intrathoracic impedance and is intended to recognize early signs of volume accumulation before physical symptoms appear. Through a recent clinical trial, the default setting for the OptiVol system functioned as a predictor of hospitalization with 76.9% sensitivity. Intrathoracic impedance monitoring is not intended to replace careful frequent clinical evaluation of the heart failure patient, but instead aims to complement traditional heart failure management practices.