Frequency of unrecognized, unreported, or underreported coronary artery and cardiovascular calcification on noncardiac chest CT.

BACKGROUND: Coronary artery calcification (CAC) is correlated with cardiovascular outcomes and, therefore, can change management. Such calcifications are identifiable on noncardiac chest CT (NCCT), although there is no standard for interpretation. However, no data are published on the frequency of these findings being reported during NCCT interpretation. METHODS: To obtain population with a high likelihood of CAC, we identified 355 patients with known (n = 136) or suspected (n = 219) coronary artery disease in whom single-photon emission CT myocardial perfusion imaging and NCCT were ordered within 1 month of each other; their mean age was 63 years, and 204 were women. Single-photon emission CT reports, NCCT reports, and retrospective NCCT image interpretations were performed by the investigators independently. RESULTS: CAC was present in 207 of the 355 patients (58% of the group) but was recorded in the final radiology report as present in only 44% of these subjects. CAC in the left main coronary artery was evident on review in 139 patients but was specified in the final report in only 1 patient. Left anterior descending CAC was evident in 188 patients but reported in only 3%. CONCLUSIONS: In this observational study, CAC on NCCT in this enriched population was often unreported. Although NCCT can indicate presence and location of CAC, these features are rarely reported, even when involving locations such as the left main coronary artery or left anterior descending artery. In view of its diagnostic and prognostic importance, evaluation of CAC should become a routine part of the interpretation of NCCT.

Single session of brief electrical stimulation immediately following crush injury enhances functional recovery of rat facial nerve.

Peripheral nerve injuries lead to a variety of pathological conditions, including paresis or paralysis when the injury involves motor axons. We have been studying ways to enhance the regeneration of peripheral nerves using daily electrical stimulation (ES) following a facial nerve crush injury. In our previous studies, ES was not initiated until 24 h after injury. The current experiment tested whether ES administered immediately following the crush injury would further decrease the time for complete recovery from facial paralysis. Rats received a unilateral facial nerve crush injury and an electrode was positioned on the nerve proximal to the crush site. Animals received daily 30 min sessions of ES for 1 d (day of injury only), 2 d, 4 d, 7 d, or daily until complete functional recovery. Untreated animals received no ES. Animals were observed daily for the return of facial function. Our findings demonstrated that one session of ES was as effective as daily stimulation at enhancing the recovery of most functional parameters. Therefore, the use of a single 30 min session of ES as a possible treatment strategy should be studied in human patients with paralysis as a result of acute nerve injuries.