Alternative diagnoses at paediatric appendicitis MRI.

As the utilization of MRI in the assessment for paediatric appendicitis increases in clinical practice, it is important to recognize alternative diagnoses as the cause of abdominal pain. The purpose of this review is to share our institution's experience using MRI in the evaluation of 510 paediatric patients presenting with suspected appendicitis over a 30 month interval (July 2011 to December 2013). An alternative diagnosis was documented in 98/510 (19.2%) patients; adnexal pathology (6.3%, n = 32), enteritis-colitis (6.3%, n = 32), and mesenteric adenitis (2.2%, n = 11) comprised the majority of cases. These common entities and other less frequent illustrative cases obtained during our overall institutional experience with MRI for suspected appendicitis are reviewed.

Long-term outcomes in patients with schizophrenia treated with risperidone long-acting injection or oral antipsychotics in Spain: results from the electronic Schizophrenia Treatment Adherence Registry (e-STAR).

BACKGROUND: The electronic Schizophrenia Treatment Adherence Registry (e-STAR) is a prospective, observational study of patients with schizophrenia designed to evaluate long-term treatment outcomes in routine clinical practice. METHODS: Parameters were assessed at baseline and at 3 month intervals for 2 years in patients initiated on risperidone long-acting injection (RLAI) (n=1345) or a new oral antipsychotic (AP) (n=277; 35.7% and 36.5% on risperidone and olanzapine, respectively) in Spain. Hospitalization prior to therapy was assessed by a retrospective chart review. RESULTS: At 24 months, treatment retention (81.8% for RLAI versus 63.4% for oral APs, p<0.0001) and reduction in Clinical Global Impression Severity scores (-1.14 for RLAI versus -0.94 for APs, p=0.0165) were significantly higher with RLAI. Compared to the pre-switch period, RLAI patients had greater reductions in the number (reduction of 0.37 stays per patient versus 0.2, p<0.05) and days (18.74 versus 13.02, p<0.01) of hospitalizations at 24 months than oral AP patients. CONCLUSIONS: This 2 year, prospective, observational study showed that, compared to oral antipsychotics, RLAI was associated with better treatment retention, greater improvement in clinical symptoms and functioning, and greater reduction in hospital stays and days in hospital in patients with schizophrenia. Improved treatment adherence, increased efficacy and reduced hospitalization with RLAI offer the opportunity of substantial therapeutic improvement in schizophrenia.

X-ray imaging with amorphous selenium: pulse height measurements of avalanche gain fluctuations.

Avalanche multiplication in amorphous selenium (a-Se) can provide a large, adjustable gain for active matrix flat panel imagers (AMFPI), enabling quantum noise limited x-ray imaging during both radiography and fluoroscopy. In the case of direct conversion AMFPI, the multiplication factor for each x ray is a function of its depth of interaction, and the resulting variations in gain can reduce the detective quantum efficiency (DQE) of the system. An experimental method was developed to measure gain fluctuations by analyzing images of individual x rays that were obtained using a video camera with an a-Se target operated in avalanche mode. Pulse height spectra (PHS) of the charge produced per x ray were recorded for monoenergetic 30.9, 49.4, and 73.8 keV x-ray sources. The rapid initial decay and long tail of each PHS can be explained by a model in which positive charge dominates the initiation of avalanche. The Swank information factor quantifies the effect of gain fluctuation on DQE and was calculated from the PHS. The information factor was found to be 0.5 for a 25 microm a-Se layer with a maximum gain of approximately 300. Changing the energy of the incident x ray influenced the range of the primary photoelectron and noticeably affected the tail of the experimental PHS, but did not significantly change the avalanche Swank factor.