Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.993
Filtrar
1.
Medicine (Baltimore) ; 99(40): e22535, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019460

RESUMO

RATIONALE: Adolescent wrist trauma can cause epiphyseal dysplasia and even distal radius deformity malunion. At present, there is no uniform treatment standard for the malunion of the distal radius of adolescents. Osteotomy and autologous bone grafting are currently one of the effective ways to treat the disease. We treated an adolescent patient with distal radius deformity malunion, and used this surgical method to treat the patient and achieved satisfactory results. PATIENT CONCERNS: A 16-year-old boy suffered from a serious distal radius deformity after trauma of the left wrist 8 years ago. DIAGNOSES: Physical examination, X-rays examination, high-resolution computed tomography scan, and 3-dimensional reconstruction images of the affected limb helped us diagnose the distal radius fracture malunion. INTERVENTIONS: The fracture malunion was treated by osteotomy and autologous iliac bone grafting. OUTCOMES: At the 2-year follow-up, wrist flexion returned to 68°, wrist dorsiflexion to 55°, radial deviation to 14°, ulnar deviation to 12°, forearm pronation to 75°, supination to 67°. Grip strength increased to 35.1 kg after 2 years of operation, recovered to 87% of the uninjured side. Quick DASH score at 2-year follow-up was 9. No complication, such as nonunion or infection, was observed. LESSONS: This rare case provides valuable insights for hand surgeons. High-resolution computed tomography scan and 3-dimensional reconstruction can help us effectively diagnose wrist diseases. Small lesions on the articular surface of the distal radius will change the position and function of the wrist joint, and cause traumatic arthritis of the wrist joint. Therefore, it is very important to reconstruct the normal structure of the distal radius articular surface. Osteotomy and autologous iliac bone grafting are effective treatments for serious distal radius fracture malunion in the adolescent patient. During the operation, care should be taken to protect the osteoepiphysis to avoid bone dysplasia.


Assuntos
Fraturas Mal-Unidas/cirurgia , Osteotomia/métodos , Fraturas do Rádio/complicações , Transplante Autólogo/métodos , Adolescente , Assistência ao Convalescente , Transplante Ósseo/métodos , Fraturas Mal-Unidas/diagnóstico por imagem , Humanos , Ílio/transplante , Processamento de Imagem Assistida por Computador/instrumentação , Masculino , Radiografia/métodos , Amplitude de Movimento Articular , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Articulação do Punho/fisiologia
2.
Medicine (Baltimore) ; 99(40): e22538, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019462

RESUMO

The current studies revealed inconsistent relationship between reproductive factors and osteoarthritis. Community-based research has not been conducted in China. The study was to examine the association of reproductive factors with the prevalence of knee osteoarthritis (OA).Through a multistage stratified random sampling method, 10 streets or villages from 5 cities in Hunan province were randomly selected, a total 2746 eligible women aged 50 to 83 were recruited in this cross-sectional study. A structured questionnaire including demographic factors, socio-economic status, reproductive factors, and knee OA was used. According to the criteria of American College of Rheumatology, clinical knee OA was assessed by doctors in community or village health clinics for knee pain, age, morning stiffness, crepitus on active motion or for knee pain, morning stiffness, crepitus on active motion, and tenderness of the bony navigation of the joint. Self-reported age of menarche, parity, abortion history, and menopausal status were collected.The prevalence of knee OA was 13.44%. Abortion is associated with knee OA (odds ratio [OR] = 1.271, 95% confidence interval [CI] = 1.007, 1.606), but age at menarche, parity, and menopausal status were not the factors. Furthermore, age (OR = 1.040, 95% CI = 1.020, 1.060), weight (OR = 1.019, 95% CI = 1.004, 1.035), higher education level (OR = 1.530, 95% CI = 1.121, 2.088), higher monthly household income (OR = .583, 95% CI = 0.441, 0.770 for 3000-4999 ¥ and OR = 0.599, 95% CI = 0.431, 0.833 for 5000 ¥ or more), and chronic gastritis (OR = 3.364, 95% CI = 2.548, 4.442) were associated with knee OA.Abortion may increase the risk of knee OA. Special attention should be paid to women with a history of abortion, and women who are planning to abort should be informed of the risk of knee OA later in life. The relationship between abortion and knee OA should be interpreted with caution and further confirmed.


Assuntos
Aborto Espontâneo/epidemiologia , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/etiologia , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/patologia , Dor/diagnóstico , Dor/epidemiologia , Prevalência , Radiografia/métodos , Medição de Risco , Autorrelato , Classe Social , Inquéritos e Questionários
3.
Medicine (Baltimore) ; 99(40): e22578, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019472

RESUMO

RATIONALE: Exact restoration of the rotation center in total hip arthroplasty (THA) is technically challenging in patients with end-stage osteoarthritis due to developmental dysplasia of the hip (DDH), especially in the Crowe type II and III procedures. The technical difficulty is attributable to the complex acetabular changes. In this study, a novel 3-dimensional (3D) printed integral customized acetabular prosthesis for anatomical rotation restoration in THA for DDH Crowe type III was developed using patient-specific Computer-aided design and additive manufacturing (AM) methods. PATIENT CONCERNS: A 69-year-old female patient had developed left hip joint pain and restricted movement for 40 years; the symptoms had increased in the past 5 months. Pain, limited motion of the left hip joint, and lower limb length discrepancy were noted during physical examination. DIAGNOSIS: The patient was diagnosed with left hip end-stage osteoarthritis secondary to DDH (Crowe type III). INTERVENTION: A 3D printed acetabulum model was manufactured and a simulated operation was performed to improve the accuracy of reconstruction of the rotation center and bone defect. A 3D printed titanium alloy integral customized acetabular prosthesis was designed according to the result of simulated operation. The integral customized prothesis was implanted subsequently via the posterolateral approach. Radiography of the pelvis and Harris score assessment were performed during the perioperative period as well as at the 6- and 12-month follow-up. OUTCOMES: The 3D printed integral customized acetabular prosthesis matched precisely with the reamed acetabulum. The rotation center was restored and the bone defect was exactly reconstructed. There were no signs of prosthetic loosening at the 12-month follow-up. The Harris score gradually improved during the follow-up period. LESSONS: Satisfactory results of hip rotation restoration and bone defect reconstruction could be achieved by using 3D printed integral customized acetabular prosthesis, which provides a promising way to reconstruct the acetabulum in patients with DDH anatomically and rapidly for THA.


Assuntos
Artroplastia de Quadril/instrumentação , Luxação Congênita de Quadril/patologia , Prótese de Quadril/efeitos adversos , Osteoartrite do Quadril/cirurgia , Impressão Tridimensional/instrumentação , Assistência ao Convalescente , Idoso , Feminino , Luxação Congênita de Quadril/classificação , Luxação Congênita de Quadril/complicações , Prótese de Quadril/tendências , Humanos , Desigualdade de Membros Inferiores/diagnóstico , Desigualdade de Membros Inferiores/etiologia , Osteoartrite do Quadril/etiologia , Período Perioperatório/normas , Radiografia/métodos , Rotação , Resultado do Tratamento
4.
Medicine (Baltimore) ; 99(39): e22324, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991442

RESUMO

RATIONALE: Coracoid processes (CPs) fracture with acromioclavicular (AC) joint dislocation are extremely rare. This combined injury has brought many challenges to surgeons, and the mechanism underlying the injury is still not fully understood. There is no clear consensus on its treatment. PATIENT CONCERNS: Here, we describe a CP fracture with AC joint dislocation in a middle-aged manual worker. DIAGNOSIS: Radiographs showed a fracture of the base of the CP and a third-degree AC joint separation. INTERVENTIONS: The patient was treated surgically with open reduction and internal fixation of the AC joint by LCP clavicle hook plate, and the CP was fixed with a 3.5 mm diameter cannulated screw. OUTCOMES: Three months after the operation, shoulder function was completely restored, and the affected shoulder had full mobility with no tenderness. Plain film radiography showed anatomical indications of the healing of these combined injuries. LESSONS: Although AC joint dislocation with CP fractures is extremely rare in adults, it is important to remind and remember that this possibility exists. In unclear cases, special radiographic films and CT are necessary. Surgical treatment of AC joint dislocation with CP fractures can provide solid stability and restore normal shoulder function with an excellent prognosis.


Assuntos
Articulação Acromioclavicular/lesões , Processo Coracoide/lesões , Fraturas Ósseas/cirurgia , Luxações Articulares/cirurgia , Articulação Acromioclavicular/diagnóstico por imagem , Articulação Acromioclavicular/patologia , Assistência ao Convalescente , Placas Ósseas/normas , Parafusos Ósseos/normas , Processo Coracoide/patologia , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/diagnóstico por imagem , Humanos , Luxações Articulares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Redução Aberta/métodos , Radiografia/métodos , Resultado do Tratamento
5.
Medicine (Baltimore) ; 99(39): e22330, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991444

RESUMO

RATIONALE: Widely applied in the treatment of severe ankle arthritis (AA), ankle distraction arthroplasty (ADA) can avoid not only the ankle range of motion loss but also ankle fusion. However, the clinical outcomes of ADA for severe AA are poorly understood. This study aims to present our clinical outcomes of severe AA treated by ADA. PATIENT CONCERNS: A 53-year-old man suffered right ankle sprain 10 years ago, endured right ankle pain and limited movement for 6 years. DIAGNOSIS: The patient was diagnosed as severe AA. INTERVENTIONS: He received ankle distraction arthroplasty. No adjuvant procedures were performed. The visual analog scale (VAS), the American Orthopaedic Foot and Ankle Society (AOFAS) score, the short-form (SF)-36 physical component summary (PCS) score and ankle activity score (AAS) were recorded to access the clinical outcomes pre- and postoperatively. Moreover, ankle joint space distance was evaluated on weight-bearing radiographs. OUTCOMES: The patient derived effective pain relief and restored a satisfactory range of movement. There was a 13-month follow-up period after frame removal. The AOFAS score improved from 56 preoperatively to 71 postoperatively. The VAS score decreased from 6 prior to surgery to 1 after surgery. The SF-36 PCS was 47.2 and 71.8 pre- and postoperative, respectively. The AAS scores were improved from 3.4 preoperatively to 7.3 postoperatively. LESSONS: ADA is reliable to achieve pain relief, functional recovery, and serve AA resolution. Besides, it is an alternative to ankle arthrodesis or total ankle arthroplasty in selected patients with severe AA.


Assuntos
Traumatismos do Tornozelo/complicações , Articulação do Tornozelo/patologia , Artrite/cirurgia , Osteogênese por Distração/efeitos adversos , Assistência ao Convalescente , Traumatismos do Tornozelo/fisiopatologia , Articulação do Tornozelo/diagnóstico por imagem , Artroplastia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Osteogênese por Distração/instrumentação , Radiografia/métodos , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Índice de Gravidade de Doença , Resultado do Tratamento , Escala Visual Analógica , Suporte de Carga
6.
Bone Joint J ; 102-B(8): 1062-1071, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32731831

RESUMO

AIMS: To determine the effectiveness of prone traction radiographs in predicting postoperative slip distance, slip angle, changes in disc height, and lordosis after surgery for degenerative spondylolisthesis of the lumbar spine. METHODS: A total of 63 consecutive patients with a degenerative spondylolisthesis and preoperative prone traction radiographs obtained since 2010 were studied. Slip distance, slip angle, disc height, segmental lordosis, and global lordosis (L1 to S1) were measured on preoperative lateral standing radiographs, flexion-extension lateral radiographs, prone traction lateral radiographs, and postoperative lateral standing radiographs. Patients were divided into two groups: posterolateral fusion or posterolateral fusion with interbody fusion. RESULTS: The mean changes in segmental lordosis and global lordosis were 7.1° (SD 6.7°) and 2.9° (SD 9.9°) respectively for the interbody fusion group, and 0.8° (SD 5.1°) and -0.4° (SD 10.1°) respectively for the posterolateral fusion-only group. Segmental lordosis (ρ = 0.794, p < 0.001) corrected by interbody fusion correlated best with prone traction radiographs. Global lumbar lordosis (ρ = 0.788, p < 0.001) correlated best with the interbody fusion group and preoperative lateral standing radiographs. The least difference in slip distance (-0.3 mm (SD 1.7 mm), p < 0.001), slip angle (0.9° (SD 5.2°), p < 0.001), and disc height (0.02 mm (SD 2.4 mm), p < 0.001) was seen between prone traction and postoperative radiographs. Regression analyses suggested that prone traction parameters best predicted correction of slip distance (Corrected Akaike's Information Criterion (AICc) = 37.336) and disc height (AICc = 58.096), while correction of slip angle (AICc = 26.453) was best predicted by extension radiographs. Receiver operating characteristic (ROC) cut-off showed, with 68.3% sensitivity and 64.5% specificity, that to achieve a 3.0° increase in segmental lordotic angle, patients with a prone traction disc height of 8.5 mm needed an interbody fusion. CONCLUSION: Prone traction radiographs best predict the slip distance and disc height correction achieved by interbody fusion for lumbar degenerative spondylolisthesis. To achieve this maximum correction, interbody fusion should be undertaken if a disc height of more than 8.5 mm is attained on preoperative prone traction radiographs. Level of Evidence: Level II Prognostic Study Cite this article: Bone Joint J 2020;102-B(8):1062-1071.


Assuntos
Fusão Vertebral/métodos , Espondilolistese/diagnóstico por imagem , Espondilolistese/terapia , Tração/métodos , Idoso , Estudos de Coortes , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Posicionamento do Paciente , Valor Preditivo dos Testes , Cuidados Pré-Operatórios/métodos , Decúbito Ventral , Curva ROC , Radiografia/métodos , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento
7.
J Pediatr Orthop ; 40(8): e690-e696, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32776771

RESUMO

PURPOSE: The debate on the treatment of type IIa supracondylar humerus fractures has yet to be resolved. The purpose of this study was to assess the factors associated with successful closed reduction and immobilization and to assess the efficacy of a novel radiographic "hourglass" angle measurement in the management of type IIa supracondylar humerus fractures within the pediatric population. METHODS: An institutional review board-approved retrospective review of all children who underwent closed reduction and casting or splinting of an isolated type IIa supracondylar humerus fractures treated at 2 pediatric hospitals from January 1, 2009 to August 31, 2016. Analyzed radiographic parameters included Baumann angle (BA), humerocondylar angle (HCA), perpendicular distance (PD) from the anterior humeral line to the capitellum, and the hourglass angle (HGA). These parameters were measured on injury radiographs (XR), postreduction XR, and at the first and final follow-up XR. The success of closed reduction was defined as maintenance of an acceptable reduction without a secondary procedure. The interobserver reliability was calculated. RESULTS: There were 77 elbows treated with closed reduction and long-arm cast or splint immobilization. Of those closed reductions, 76.62% of elbows (59/77) maintained their reduction alignment and did not require surgical treatment for percutaneous pinning. In this series, the BA was not significantly different following closed reduction ([INCREMENT]1.04 degrees; P=0.081); however, the PD ([INCREMENT]1.89 mm), HGA ([INCREMENT]7.38 degrees), and HCA ([INCREMENT]5.07 degrees) had significant improvement following closed reduction (P<0.001 for all). The use of procedural sedation during reduction was strongly associated with success, 83.05% (49/59) with sedation compared with 55.56% (10/18) success without sedation (P=0.025). Furthermore, fractures that underwent a secondary procedure had 6.20 degrees less HGA following a closed reduction (P=0.016) and required additional follow-up visits (P=0.0037). The success of type IIa supracondylar humerus fractures did not significantly differ based on sex (P=0.5684), laterality (P=0.6975), mechanism of injury (P>0.9999), location of care-emergency department versus clinic (P=0.1160), or type of fracture immobilization (P=0.7411). The mean HGA in normal elbows was 177.8 degrees. The interobserver reliability for HCA was poor [intraclass correlation coefficient (ICC)=0.342]; fair for BA (ICC=0.458); and excellent for both PD and HGA (ICC=0.769 and 0.805, respectively) (P<0.001 for all). CONCLUSIONS: Improved and acceptable radiographic parameters were achieved by a closed reduction in the majority of minimally displaced type IIa fractures treated by closed reduction and immobilization in this series. HCA upon presentation was significantly greater in successful cases, and failure to improve and maintain HGA and PD following closed reduction was associated with loss of reduction. Procedural sedation during reduction was strongly associated with success. The HGA and PD were consistent parameters used to determine effective management of type IIa fractures. This study adds support for a nonoperative closed reduction under sedation with immobilization of selected type IIa supracondylar humerus fractures.


Assuntos
Fixação Intramedular de Fraturas , Fraturas do Úmero , Úmero , Criança , Cotovelo/cirurgia , Feminino , Fixação Intramedular de Fraturas/efeitos adversos , Fixação Intramedular de Fraturas/métodos , Humanos , Fraturas do Úmero/diagnóstico , Fraturas do Úmero/cirurgia , Úmero/diagnóstico por imagem , Úmero/cirurgia , Masculino , Radiografia/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Reconstrutivos/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento
8.
Skeletal Radiol ; 49(11): 1873-1877, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: covidwho-723995

RESUMO

The ongoing coronavirus disease 2019 (COVID-19) pandemic has increased the need for safe and efficient testing as a key containment strategy. Drive-through testing with nasopharyngeal swab has been implemented in many places in the USA as it allows for expeditious testing of large numbers of patients, limits healthcare workers' risk of exposure, and minimizes the use of personal protective equipment. We present a case where the aluminum shaft of the nasopharyngeal swab fractured during specimen collection at a drive-through testing facility and was suspected to have remained in the asymptomatic patient. Initial evaluation with a series of radiographs covering the skull base, neck, chest, and abdomen did not reveal the swab. On further clinical evaluation, the swab was found endoscopically, lodged between the left inferior turbinate and nasal floor, and was removed by an otorhinolaryngologist. Using a phantom model, we aimed to delineate an imaging technique to better visualize the aluminum shaft of the nasopharyngeal swab on radiographs to help in identification. A technique using lower tube voltage (kVp) with tight collimation centered at the nasal bones area produced the best visualization of the aluminum shaft of the swab. Recognition that aluminum foreign bodies may be difficult to visualize radiographically and  optimization of radiograph acquisition technique may help guide clinical management in unusual cases. Further evaluation with computed tomography or endoscopy should be considered in suspected cases where radiographs are negative.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/instrumentação , Infecções por Coronavirus/diagnóstico , Falha de Equipamento , Corpos Estranhos/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Manejo de Espécimes/instrumentação , Idoso de 80 Anos ou mais , Alumínio , Humanos , Masculino , Pandemias , Radiografia/métodos , Instrumentos Cirúrgicos
9.
Skeletal Radiol ; 49(11): 1873-1877, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32827082

RESUMO

The ongoing coronavirus disease 2019 (COVID-19) pandemic has increased the need for safe and efficient testing as a key containment strategy. Drive-through testing with nasopharyngeal swab has been implemented in many places in the USA as it allows for expeditious testing of large numbers of patients, limits healthcare workers' risk of exposure, and minimizes the use of personal protective equipment. We present a case where the aluminum shaft of the nasopharyngeal swab fractured during specimen collection at a drive-through testing facility and was suspected to have remained in the asymptomatic patient. Initial evaluation with a series of radiographs covering the skull base, neck, chest, and abdomen did not reveal the swab. On further clinical evaluation, the swab was found endoscopically, lodged between the left inferior turbinate and nasal floor, and was removed by an otorhinolaryngologist. Using a phantom model, we aimed to delineate an imaging technique to better visualize the aluminum shaft of the nasopharyngeal swab on radiographs to help in identification. A technique using lower tube voltage (kVp) with tight collimation centered at the nasal bones area produced the best visualization of the aluminum shaft of the swab. Recognition that aluminum foreign bodies may be difficult to visualize radiographically and  optimization of radiograph acquisition technique may help guide clinical management in unusual cases. Further evaluation with computed tomography or endoscopy should be considered in suspected cases where radiographs are negative.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/instrumentação , Infecções por Coronavirus/diagnóstico , Falha de Equipamento , Corpos Estranhos/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Manejo de Espécimes/instrumentação , Idoso de 80 Anos ou mais , Alumínio , Humanos , Masculino , Pandemias , Radiografia/métodos , Instrumentos Cirúrgicos
10.
Anticancer Res ; 40(7): 3633-3643, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620602

RESUMO

BACKGROUND/AIM: With the increase in detection of non-palpable breast lesions through screening, wire-guided localisation (WGL) has long been the favoured method for preoperative localisation. However, this technique comes with several limitations. New methods have been developed, including several non-radioactive, wireless options. We aimed to assess the effectiveness of Savi Scout® localisation (SSL) through this pooled analysis and systematic review. MATERIALS AND METHODS: A number of databases were searched for records reporting data on localisation and retrieval of SSL reflectors, as well as re-excision rate. We included our own data from 20 patients (22 reflectors) at our institution. RESULTS: A total of 842 reflectors were inserted across eleven studies and our own data. Pooled analysis revealed an overall successful deployment rate of 99.64% and a successful retrieval rate of 99.64% using SSL. A statistically significant difference in re-excision rate was found in a smaller pooled analysis conducted across four studies comparing SSL and WGL (12.9% and 21.1% respectively, p<0.01). CONCLUSION: The Savi Scout® localisation system is a safe and effective alternative to WGL. It facilitates flexible scheduling by decoupling radiology and surgery interventions and may reduce the need for re-excision procedures for positive surgical margins.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Mama/diagnóstico por imagem , Mama/patologia , Radiografia/métodos , Feminino , Humanos , Margens de Excisão , Radar
12.
Recent Results Cancer Res ; 216: 3-30, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32594383

RESUMO

Since their discovery by Wilhelm Conrad Röntgen in 1895, X-rays have become the most widely available, typically fastest, and usually most cost-effective medical imaging modality today. From the early radiographic approaches using X-ray films as detectors, the portfolio of medical X-ray imaging devices developed into a large range of dedicated instrumentation for various applications. While X-ray imaging has come a long way, there are some physical properties of X-rays, which have not yet been fully exploited, and which may offer quite some room for further enhancements of current X-ray imaging equipment. Firstly, X-ray imaging today is mainly black and white, despite the fact that X-ray generators actually create a full spectrum of X-ray energies, and that the interactions of X-rays that occur within the human body are not the same for all energies and every material. Exploiting these spectral dependencies allows to not only obtain a black and white CT image, but also to obtain more molecularly specific information, which is relevant particularly in oncological precision radiology. The second aspect of X-rays, and so far in radiology mainly neglected and unused, is the physical fact that X-rays can also be interpreted in the wave picture, and not only as presently been done in the particle picture. If interpreted as waves, X-rays-just like visible light-experience a phase shift in matter, and this-if exploited correctly-can produce a new class of X-ray images, which then depict the wave interactions of X-rays with matter, rather than only the attenuating properties, as done until now.


Assuntos
Radiografia/métodos , Radiografia/tendências , Humanos , Raios X
13.
Korean J Radiol ; 21(7): 851-858, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32524785

RESUMO

Coronavirus disease 2019 (COVID-19) is a new infectious disease rapidly spreading around the world, raising global public health concerns. Radiological examinations play a crucial role in the early diagnosis and follow-up of COVID-19. Cross infection among patients and radiographers can occur in radiology departments due to the close and frequent contact of radiographers with confirmed or potentially infected patients in a relatively confined room during radiological workflow. This article outlines our experience in the emergency management procedure and infection control of the radiology department during the COVID-19 outbreak.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Controle de Infecções/métodos , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Serviço Hospitalar de Radiologia/organização & administração , Betacoronavirus , China/epidemiologia , Serviço Hospitalar de Emergência , Humanos , Radiografia/métodos , Risco
14.
Medicine (Baltimore) ; 99(26): e20839, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590777

RESUMO

Although the inverse correlation between smoking and degenerative arthritis is controversial, quantitative analysis of the correlation between lifetime cigarette smoking amount and degenerative arthritis has not been performed. We investigated the correlation between knee radiographic osteoarthritis (ROA) and lifetime cigarette smoking amount in the general population.This cross-sectional study used the Fifth and Sixth Korean National Health and Nutrition Examination Survey (2010-2013) data. Subjects included 11,638 community-dwelling adults aged ≥50 years. Knee ROA was defined as a Kellgren/Lawrence grade ≥2 on plain radiography. Lifetime cigarette smoking amount was calculated in terms of pack-year and further divided into quartile groups. Independent correlation between smoking and knee ROA was determined using odds ratios (OR) adjusted for age, sex, obesity, physical activity, and household income on multivariate logistic regression analysis.Knee ROA prevalence was 37.3%; prevalence of lifetime cigarette smokers was 26.0%. Subjects with knee ROA had higher mean age, female sex ratio, and body mass index but lower physical activity level. The adjusted logistic regression model revealed that female sex (OR, 2.110; 95% confidence interval [CI], 1.895-2.349) was significantly associated with knee ROA. Older age, obesity, and lower household income were positively correlated with knee ROA. Second-and fourth-quartile groups of smokers had the lower ROA prevalence than never-smokers (OR, 0.800; 95% CI, 0.643-0.99; OR, 0.812; 95% CI, 0.684-0.965, respectively).An inverse correlation with knee ROA was confirmed in mid-light to heavy smokers. Prospective studies are needed to reveal whether knee ROA involves smoking.


Assuntos
Fumar Cigarros/efeitos adversos , Osteoartrite do Joelho/diagnóstico , Prevalência , Idoso , Índice de Massa Corporal , Fumar Cigarros/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Osteoartrite do Joelho/classificação , Osteoartrite do Joelho/epidemiologia , Radiografia/métodos , Radiografia/estatística & dados numéricos , República da Coreia/epidemiologia , Inquéritos e Questionários
15.
Medicine (Baltimore) ; 99(26): e20869, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590790

RESUMO

RATIONALE: Pulmonary sclerosing pneumocytoma (PSP) is a rare benign tumor of the lung, mostly presented in Asian middle-aged women. Initially, it was considered as a vascular origin tumor, but then research evidence showed that it was derived from natural epithelial tissue. On imaging, this tumor may be found as a solitary well-circumscribed lung parenchymal lesion, and is often located in juxtapleural or juxtafissural positions. On histopathology, it consists of cuboidal surface cells and stromal round cells, both of which are positive for thyroid transcription factor-1. Here we report a case of a young PSP male patient and review the relevant literature in order to improve our understanding of this disease. PATIENT CONCERNS: An 18-year-old man was referred to our hospital after accidentally finding a lesion on chest X-ray. Contrast-enhanced computed tomography showed a soft tissue mass with homogeneous enhancement in the left lower lobe posterior segment. DIAGNOSES: The diagnosis of PSPs was confirmed by histopathological examination. INTERVENTIONS AND OUTCOMES: The patient underwent a thoracoscopic wedge resection and was followed-up after that. One month later, he had good performance status with no recurrent tumors. LESSONS: PSP in a young man is really uncommon, and is confused with malignant tumors. A histopathological examination is considered as the diagnostic gold standard for this uncommon tumor. Surgery is the main treatment.


Assuntos
Hemangioma Esclerosante Pulmonar/diagnóstico , Adolescente , Biópsia com Agulha de Grande Calibre/métodos , Humanos , Masculino , Hemangioma Esclerosante Pulmonar/fisiopatologia , Radiografia/métodos , Tomografia Computadorizada por Raios X/métodos
16.
Acad Radiol ; 27(8): 1147-1153, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32507612

RESUMO

RATIONALE AND OBJECTIVES: Social distancing mandates due to COVID-19 have necessitated adaptations to radiology trainee workflow and educational practices, including the radiology "readout." We describe how a large academic radiology department achieved socially distant "remote readouts," provide trainee and attending perspectives on this early experience, and propose ways by which "remote readouts" can be used effectively by training programs beyond COVID-19. MATERIALS AND METHODS: Beginning March 2020, radiologists were relocated to workspaces outside of conventional reading rooms. Information technologies were employed to allow for "remote readouts" between trainees and attendings. An optional anonymous open-ended survey regarding remote readouts was administered to radiology trainees and attendings as a quality improvement initiative. From the responses, response themes were abstracted using thematic analysis. Descriptive statistics of the qualitative data were calculated. RESULTS: Radiologist workstations from 14 traditional reading rooms were relocated to 36 workspaces across the hospital system. Two models of remote readouts, synchronous and asynchronous, were developed, facilitated by commercially available information technologies. Thirty-nine of 105 (37%) trainees and 42 of 90 (47%) attendings responded to the survey. Main response themes included: social distancing, technology, autonomy/competency, efficiency, education/feedback and atmosphere/professional relationship. One hundred and forty-eight positive versus 97 negative comments were reported. Social distancing, technology, and autonomy/competency were most positively rated. Trainees and attending perspectives differed regarding the efficiency of remote readouts. CONCLUSION: "Remote readouts," compliant with social distancing measures, are feasible in academic radiology practice settings. Perspectives from our initial experience provide insight into how this can be accomplished, opportunities for improvement and future application, beyond the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Educação a Distância , Pandemias , Pneumonia Viral , Radiografia/métodos , Radiologia/educação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Educação/métodos , Educação/organização & administração , Educação a Distância/métodos , Educação a Distância/tendências , Eficiência Organizacional , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
17.
Acad Radiol ; 27(8): 1154-1161, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32553278

RESUMO

RATIONALE AND OBJECTIVES: The educational value of the daily resident readout, a vital component of resident training, has been markedly diminished due to a significant decrease in imaging volume and case mix diversity. The goal of this study was to create a "simulated" daily readout (SDR) to restore the educational value of the daily readout. MATERIALS AND METHODS: To create the SDR the following tasks were performed; selection of cases for a daily worklist for each resident rotation, comprising a combination of normal and abnormal cases; determination of the correct number of cases and the appropriate mix of imaging modalities for each worklist; development of an "educational" environment consisting of separate "instances" of both our Picture Archive Communication System and reporting systems; and the anonymization of all of the cases on the worklists. Surveys of both residents and faculty involved in the SDR were performed to assess its effectiveness. RESULTS: Thirty-two residents participated in the SDR. The daily worklists for the first 20 days of the SDR included 3682 cases. An average of 480 cases per day was dictated by the residents. Surveys of the residents and the faculty involved in the SDR demonstrated that both agreed that the SDR effectively mimics a resident's daily work on rotations and preserves resident education during the Coronavirus Disease 2019 crisis. CONCLUSION: The development of the SDR provided an effective method of preserving the educational value of the daily readout experience of radiology residents, despite severe decreases in imaging exam volume and case mix diversity during the Coronavirus Disease 2019 pandemic.


Assuntos
Infecções por Coronavirus , Educação a Distância , Internato e Residência , Pandemias , Pneumonia Viral , Radiografia/métodos , Radiologia/educação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Educação a Distância/métodos , Educação a Distância/tendências , Feminino , Humanos , Internato e Residência/métodos , Internato e Residência/tendências , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Treinamento por Simulação , Inquéritos e Questionários
18.
Acad Radiol ; 27(8): 1162-1172, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32571648

RESUMO

RATIONALE AND OBJECTIVES: The COVID-19 pandemic has forced rapid evolution of the healthcare environment. Efforts to mitigate the spread of the virus through social distancing and shelter-at-home edicts have unintended consequences upon clinical and educational missions and mental well-being of radiology departments. We sought to understand the impact of the COVID-19 pandemic on radiology residencies with respect to the educational mission and perceptions of impact on well-being. MATERIALS AND METHODS: This study was IRB exempt. An anonymous 22 question survey regarding the impact of COVID-19 pandemic on educational and clinical missions of residencies, its perceived impact upon morale of radiologists and trainees and a query of innovative solutions devised in response, was emailed to the Association of Program Directors in Radiology membership. Survey data were collected using SurveyMonkey (San Mateo, California). RESULTS: Respondents felt the COVID-19 pandemic has negatively impacted their residency programs. Regarding the educational mission impact, 70.1% (75/107) report moderate/marked negative impact and 2.8% (3/107) that educational activities have ceased. Regarding the pandemic's impact on resident morale, 44.8% (48/107) perceive moderate/marked negative effect; perceived resident morale in programs with redeployment is significantly worse with 57.1% (12/21) reporting moderate/marked decrease. Respondents overwhelmingly report adequate resident access to mental health resources during the acute phase of the pandemic (88.8%, 95/107). Regarding morale of program directors, 61% (65/106) report either mild or marked decreased morale. Program innovations reported by program directors were catalogued and shared. CONCLUSION: The COVID-19 pandemic has markedly impacted the perceived well-being and educational missions of radiology residency programs across the United States.


Assuntos
Infecções por Coronavirus , Internato e Residência , Saúde Mental/tendências , Pandemias , Pneumonia Viral , Radiografia/métodos , Radiologistas/psicologia , Radiologia/educação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Internato e Residência/métodos , Internato e Residência/tendências , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Inquéritos e Questionários , Estados Unidos/epidemiologia
19.
Acad Radiol ; 27(8): 1154-1161, 2020 08.
Artigo em Inglês | MEDLINE | ID: covidwho-608499

RESUMO

RATIONALE AND OBJECTIVES: The educational value of the daily resident readout, a vital component of resident training, has been markedly diminished due to a significant decrease in imaging volume and case mix diversity. The goal of this study was to create a "simulated" daily readout (SDR) to restore the educational value of the daily readout. MATERIALS AND METHODS: To create the SDR the following tasks were performed; selection of cases for a daily worklist for each resident rotation, comprising a combination of normal and abnormal cases; determination of the correct number of cases and the appropriate mix of imaging modalities for each worklist; development of an "educational" environment consisting of separate "instances" of both our Picture Archive Communication System and reporting systems; and the anonymization of all of the cases on the worklists. Surveys of both residents and faculty involved in the SDR were performed to assess its effectiveness. RESULTS: Thirty-two residents participated in the SDR. The daily worklists for the first 20 days of the SDR included 3682 cases. An average of 480 cases per day was dictated by the residents. Surveys of the residents and the faculty involved in the SDR demonstrated that both agreed that the SDR effectively mimics a resident's daily work on rotations and preserves resident education during the Coronavirus Disease 2019 crisis. CONCLUSION: The development of the SDR provided an effective method of preserving the educational value of the daily readout experience of radiology residents, despite severe decreases in imaging exam volume and case mix diversity during the Coronavirus Disease 2019 pandemic.


Assuntos
Infecções por Coronavirus , Educação a Distância , Internato e Residência , Pandemias , Pneumonia Viral , Radiografia/métodos , Radiologia/educação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Educação a Distância/métodos , Educação a Distância/tendências , Feminino , Humanos , Internato e Residência/métodos , Internato e Residência/tendências , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Treinamento por Simulação , Inquéritos e Questionários
20.
Acad Radiol ; 27(8): 1162-1172, 2020 08.
Artigo em Inglês | MEDLINE | ID: covidwho-597774

RESUMO

RATIONALE AND OBJECTIVES: The COVID-19 pandemic has forced rapid evolution of the healthcare environment. Efforts to mitigate the spread of the virus through social distancing and shelter-at-home edicts have unintended consequences upon clinical and educational missions and mental well-being of radiology departments. We sought to understand the impact of the COVID-19 pandemic on radiology residencies with respect to the educational mission and perceptions of impact on well-being. MATERIALS AND METHODS: This study was IRB exempt. An anonymous 22 question survey regarding the impact of COVID-19 pandemic on educational and clinical missions of residencies, its perceived impact upon morale of radiologists and trainees and a query of innovative solutions devised in response, was emailed to the Association of Program Directors in Radiology membership. Survey data were collected using SurveyMonkey (San Mateo, California). RESULTS: Respondents felt the COVID-19 pandemic has negatively impacted their residency programs. Regarding the educational mission impact, 70.1% (75/107) report moderate/marked negative impact and 2.8% (3/107) that educational activities have ceased. Regarding the pandemic's impact on resident morale, 44.8% (48/107) perceive moderate/marked negative effect; perceived resident morale in programs with redeployment is significantly worse with 57.1% (12/21) reporting moderate/marked decrease. Respondents overwhelmingly report adequate resident access to mental health resources during the acute phase of the pandemic (88.8%, 95/107). Regarding morale of program directors, 61% (65/106) report either mild or marked decreased morale. Program innovations reported by program directors were catalogued and shared. CONCLUSION: The COVID-19 pandemic has markedly impacted the perceived well-being and educational missions of radiology residency programs across the United States.


Assuntos
Infecções por Coronavirus , Internato e Residência , Saúde Mental/tendências , Pandemias , Pneumonia Viral , Radiografia/métodos , Radiologistas/psicologia , Radiologia/educação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Humanos , Internato e Residência/métodos , Internato e Residência/tendências , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Inquéritos e Questionários , Estados Unidos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA