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1.
Can Assoc Radiol J ; 64(2): 108-18, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23541828

RESUMO

Sonography is the primary imaging modality for the evaluation of pelvic pain in female patients, especially if gynaecological pathology is suspected. However, computed tomography (CT) is frequently used in patients who present to emergency departments (and elsewhere) with otherwise nonspecific abdominal and pelvic pain and may be the first imaging modality to demonstrate an acute gynaecological abnormality. Computed tomography can also be used prospectively in selected patients to further evaluate findings initially identified on sonography, although to reduce radiation exposure, magnetic resonance imaging is being used more frequently in this situation. The purpose of this article is to discuss the spectrum of gynaecological findings of the acute female pelvis that may be identified on CT by the emergency radiologist and by the general radiologist, with a brief review of the imaging literature of each specific diagnosis.


Assuntos
Abdome Agudo/diagnóstico por imagem , Doenças dos Genitais Femininos/diagnóstico por imagem , Dor Pélvica/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Meios de Contraste , Feminino , Humanos , Gravidez , Proteção Radiológica
2.
J Clin Invest ; 130(5): 2270-2285, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31961822

RESUMO

BACKGROUNDGlucose-6-phosphate dehydrogenase (G6PD) deficiency decreases the ability of red blood cells (RBCs) to withstand oxidative stress. Refrigerated storage of RBCs induces oxidative stress. We hypothesized that G6PD-deficient donor RBCs would have inferior storage quality for transfusion as compared with G6PD-normal RBCs.METHODSMale volunteers were screened for G6PD deficiency; 27 control and 10 G6PD-deficient volunteers each donated 1 RBC unit. After 42 days of refrigerated storage, autologous 51-chromium 24-hour posttransfusion RBC recovery (PTR) studies were performed. Metabolomics analyses of these RBC units were also performed.RESULTSThe mean 24-hour PTR for G6PD-deficient subjects was 78.5% ± 8.4% (mean ± SD), which was significantly lower than that for G6PD-normal RBCs (85.3% ± 3.2%; P = 0.0009). None of the G6PD-normal volunteers (0/27) and 3 G6PD-deficient volunteers (3/10) had PTR results below 75%, a key FDA acceptability criterion for stored donor RBCs. As expected, fresh G6PD-deficient RBCs demonstrated defects in the oxidative phase of the pentose phosphate pathway. During refrigerated storage, G6PD-deficient RBCs demonstrated increased glycolysis, impaired glutathione homeostasis, and increased purine oxidation, as compared with G6PD-normal RBCs. In addition, there were significant correlations between PTR and specific metabolites in these pathways.CONCLUSIONBased on current FDA criteria, RBCs from G6PD-deficient donors would not meet the requirements for storage quality. Metabolomics assessment identified markers of PTR and G6PD deficiency (e.g., pyruvate/lactate ratios), along with potential compensatory pathways that could be leveraged to ameliorate the metabolic needs of G6PD-deficient RBCs.TRIAL REGISTRATIONClinicalTrials.gov NCT04081272.FUNDINGThe Harold Amos Medical Faculty Development Program, Robert Wood Johnson Foundation grant 71590, the National Blood Foundation, NIH grant UL1 TR000040, the Webb-Waring Early Career Award 2017 by the Boettcher Foundation, and National Heart, Lung, and Blood Institute grants R01HL14644 and R01HL148151.


Assuntos
Doadores de Sangue , Preservação de Sangue , Transfusão de Eritrócitos , Eritrócitos/metabolismo , Deficiência de Glucosefosfato Desidrogenase/sangue , Adulto , Eritrócitos/patologia , Feminino , Deficiência de Glucosefosfato Desidrogenase/patologia , Humanos , Masculino
3.
Curr Probl Diagn Radiol ; 45(6): 361-369, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27316223

RESUMO

Radiology residency training has undergone substantial changes, including increased utilization of night float systems, late and/or overnight attending radiology in-house coverage (LOAR), and restructuring of the radiology boards. The purpose of this study is to evaluate radiology residents' perceptions regarding these changes and their impact on resident training using an anonymous, web-based survey that was distributed to radiology residents across the United States. A total of 345 current radiology residents completed the survey. A substantial number of radiology residents perceive that LOARs have negative impact on their development of independence and efficiency during the on call period. Residents are concerned about the timing of the core exam and match fellowship interviews, the timing of the certifying exam, and that graduating as board-eligible radiologists will harm their job search.


Assuntos
Atitude do Pessoal de Saúde , Bolsas de Estudo/métodos , Internato e Residência/estatística & dados numéricos , Radiologistas/psicologia , Radiologia/educação , Carga de Trabalho/psicologia , Humanos , Internato e Residência/métodos , Inquéritos e Questionários , Estados Unidos , Carga de Trabalho/estatística & dados numéricos
4.
Neuroimaging Clin N Am ; 24(2): 327-35, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24792611

RESUMO

Primary or metastatic spine tumors can present with pain and/or neurologic compromise depending on their location within the spinal axis. Metastases and multiple myeloma comprise most of these lesions. Management of spinal tumors includes surgical decompression with stabilization (neo), adjuvant chemotherapy and radiation therapy, curettage, bone grafting, bone marrow replacement, and palliative treatment with vertebral augmentation. Pre- and postoperative imaging plays a critical role in the diagnosis and management of patients with spinal tumors. This article reviews postoperative imaging of the spine, including imaging protocols, immediate and long-term routine imaging findings, and emergent findings in symptomatic patients.


Assuntos
Neuroimagem/métodos , Complicações Pós-Operatórias/diagnóstico , Neoplasias da Coluna Vertebral/cirurgia , Terapia Combinada , Comportamento Cooperativo , Imagem de Difusão por Ressonância Magnética/métodos , Falha de Equipamento , Seguimentos , Humanos , Interpretação de Imagem Assistida por Computador , Comunicação Interdisciplinar , Imageamento por Ressonância Magnética/métodos , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/cirurgia , Neoplasia Residual/diagnóstico , Neoplasia Residual/cirurgia , Exame Neurológico , Tomografia por Emissão de Pósitrons/métodos , Complicações Pós-Operatórias/cirurgia , Reoperação , Fusão Vertebral/instrumentação , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias da Coluna Vertebral/secundário , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos
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