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Full-Text Articles in Radiology

The Effects Of Moderate-Severe Plaque Psoriasis On Patient Well-Being And Prevention Of Flares, Glenn Devera Dec 2020

The Effects Of Moderate-Severe Plaque Psoriasis On Patient Well-Being And Prevention Of Flares, Glenn Devera

Nursing | Senior Theses

Psoriasis is a chronic skin condition that is indicated by red, patchy and scaly skin that can be painful when irritated. Patients with psoriasis have an increased risk for a number of chronic diseases. Despite the expansion of treatments for moderate-to-severe psoriasis over the last decade, patients may still find that treatment strategies are not as successful, leaving them dissatisfied with their treatments. A relationship built upon trust between the nurse and the patient diagnosed with psoriasis may serve to help ensure optimal care. A comprehensive literature review was performed and found that best practices for patient management need to ...


Cortical Iron Disrupts Functional Connectivity Networks Supporting Working Memory Performance In Older Adults, Valentinos Zachariou, Christopher E. Bauer, Elayna R. Seago, Flavius D. Raslau, David K. Powell, Brian T. Gold Dec 2020

Cortical Iron Disrupts Functional Connectivity Networks Supporting Working Memory Performance In Older Adults, Valentinos Zachariou, Christopher E. Bauer, Elayna R. Seago, Flavius D. Raslau, David K. Powell, Brian T. Gold

Neuroscience Faculty Publications

Excessive brain iron negatively affects working memory and related processes but the impact of cortical iron on task-relevant, cortical brain networks is unknown. We hypothesized that high cortical iron concentration may disrupt functional circuitry within cortical networks supporting working memory performance. Fifty-five healthy older adults completed an N-Back working memory paradigm while functional magnetic resonance imaging (fMRI) was performed. Participants also underwent quantitative susceptibility mapping (QSM) imaging for assessment of non-heme brain iron concentration. Additionally, pseudo continuous arterial spin labeling scans were obtained to control for potential contributions of cerebral blood volume and structural brain images were used to control ...


Organic Field-Effect Transistors As Flexible, Tissue-Equivalent Radiation Dosimeters In Medical Applications, Andrew M. Zeidell, Tong Ren, David S. Filston, Hamna F. Iqbal, Emma Holland, J. Daniel Bourland, John E. Anthony, Oana D. Jurchescu Sep 2020

Organic Field-Effect Transistors As Flexible, Tissue-Equivalent Radiation Dosimeters In Medical Applications, Andrew M. Zeidell, Tong Ren, David S. Filston, Hamna F. Iqbal, Emma Holland, J. Daniel Bourland, John E. Anthony, Oana D. Jurchescu

Chemistry Faculty Publications

Radiation therapy is one of the most prevalent procedures for cancer treatment, but the risks of malignancies induced by peripheral beam in healthy tissues surrounding the target is high. Therefore, being able to accurately measure the exposure dose is a critical aspect of patient care. Here a radiation detector based on an organic field‐effect transistor (RAD‐OFET) is introduced, an in vivo dosimeter that can be placed directly on a patient's skin to validate in real time the dose being delivered and ensure that for nearby regions an acceptable level of low dose is being received. This device ...


Impact Of The Covid-19 Pandemic On Emergency Department Ct For Suspected Diverticulitis: A Natural Experiment To Explain Patients’ And Clinicians’ Assessment Of Risk And Willingness To Undergo Ct Scanning?, Averi L. Gibson, Byron Y. Chen, Max P. Rosen, S. Nicolas Paez, Hao S. Lo Sep 2020

Impact Of The Covid-19 Pandemic On Emergency Department Ct For Suspected Diverticulitis: A Natural Experiment To Explain Patients’ And Clinicians’ Assessment Of Risk And Willingness To Undergo Ct Scanning?, Averi L. Gibson, Byron Y. Chen, Max P. Rosen, S. Nicolas Paez, Hao S. Lo

COVID-19 Publications by UMMS Authors

Purpose: This study examined the impact of the COVID-19 pandemic on emergency department CT use for acute non-traumatic abdominal pain, to better understand why imaging volume so drastically decreased during the COVID-19 pandemic.

Methods: This was a retrospective review of emergency imaging volumes from January 5 to May 30, 2020. Weekly volume data were collected for total imaging studies, abdominopelvic CT, and abdominopelvic CTs positive for common causes of acute non-traumatic abdominal pain. Two emergency radiology attendings scored all diverticulitis cases independently and weekly volume data for uncomplicated and complicated diverticulitis cases was also collected. Volume data prior to and ...


Detection Of Left Ventricular Thrombi On Cardiac Magnetic Resonance Viability Studies, Donya Ahmed Alhassan, Khawaja Bilal Waheed, Muhammad Nasim Sharif, Muhammad Zia Ulhassan, Fazal Ghaffar, Khaled Saleh Saleem, Emad Fouad Mahmoud Said, Bayan Mohammed Altalaq, Zechariah Jebakumar Arulanantham, Ahmad Omar Qarmash Aug 2020

Detection Of Left Ventricular Thrombi On Cardiac Magnetic Resonance Viability Studies, Donya Ahmed Alhassan, Khawaja Bilal Waheed, Muhammad Nasim Sharif, Muhammad Zia Ulhassan, Fazal Ghaffar, Khaled Saleh Saleem, Emad Fouad Mahmoud Said, Bayan Mohammed Altalaq, Zechariah Jebakumar Arulanantham, Ahmad Omar Qarmash

Journal of the Saudi Heart Association

Objective: To highlight detection of left ventricular thrombi on cardiac magnetic resonance (CMR) viability studies.

Method: This retrospective observational study was conducted in the Radiology Department at our Hospital in Dhahran, from April 2015-2019. All recently re-perfused (post-percutaneous coronary intervention/ PCI) patients with ST-segment elevation myocardial infarctions (STEMI), having low ejection fractions (

Results: Of the 125 patients, most were men (71.2%) with a mean age of 56.78 years. Eleven patients had left ventricular thrombi (8.8%), and most of these were anterior wall infarctions with low ejection fractions (

Conclusion: Left ventricular thrombi can be detected on cardiac viability ...


Dual X-Ray Absorptiometry Has Limited Utility In Detecting Bone Pathology In Children With Hypophosphatasia: A Pooled Post Hoc Analysis Of Asfotase Alfa Clinical Trial Data., Jill H. Simmons, Eric T. Rush, Anna Petryk, Shanggen Zhou, Gabriel Á. Martos-Moreno Aug 2020

Dual X-Ray Absorptiometry Has Limited Utility In Detecting Bone Pathology In Children With Hypophosphatasia: A Pooled Post Hoc Analysis Of Asfotase Alfa Clinical Trial Data., Jill H. Simmons, Eric T. Rush, Anna Petryk, Shanggen Zhou, Gabriel Á. Martos-Moreno

Manuscripts, Articles, Book Chapters and Other Papers

Asfotase alfa is an enzyme replacement therapy approved for treatment of patients with pediatric-onset hypophosphatasia (HPP), a rare, inherited, systemic disease causing impaired skeletal mineralization, short stature, and reduced physical function in children. The role of dual X-ray absorptiometry (DXA) in the assessment of children with HPP has been insufficiently explored. This post hoc analysis included pooled DXA data from 2 open-label, multicenter studies in 19 children with HPP. The study population was aged ≥5 to <18 years and had received asfotase alfa for ≤6.6 years at enrollment (male: 79%; median age at enrollment: 10.4 y [range: 5.9-16.7]; treatment duration: 6.3 y [range: 0.1-6.6]. Baseline height Z-scores indicated short stature (median [min, max]: -1.26 [-6.6, 0]); mean [SD]: -2.30 [1.97]), thus requiring height adjustment of DXA Z-scores. At Baseline, few patients had height-adjusted bone mineral density (BMDht) Z-scores of -2 or less for whole body (n = 3) or lumbar spine (n = 5). In treated patients, mean whole body and lumbar spine BMDhtZ-scores did not change over time, but whole body and lumbar spine height- adjusted bone mineral content (BMCht) Z-scores increased significantly from Baseline to Last Assessment (P ≤ 0.0056). Improvements in Radiographic Global Impression of Change (RGI-C) scale scores correlated significantly with increases in whole body and lumbar spine BMChtZ-scores (P < 0.05) but not BMDhtZ-Scores. Improvements in Rickets Severity Score (RSS) correlated significantly with increases in lumbar spine BMDhtZ-scores and whole body BMCht Z-scores (P < 0.05). No significant correlations were observed between any DXA and bone histomorphometry measure. These findings suggest that DXA BMD Z-scores, which are commonly used in clinical practice, have limited utility in assessing deficient bone mineralization in patients with HPP. Although BMChtZ-scores increased significantly over time with asfotase alfa therapy, the lack of significant changes in more than one DXA parameter suggests that this tool may not be useful in everyday clinical practice. Furthermore, the use of BMC as an independent metric is not typical or recommended by guidelines. Complementary measures, such as skeletal radiographs supplemented with age-appropriate functional assessments, should be considered.


Radiology Education And The Quality Of Care: Radiation Dose, Melissa R. B. Foster Jul 2020

Radiology Education And The Quality Of Care: Radiation Dose, Melissa R. B. Foster

Journal of Global Radiology

The purpose of this quantitative, quasi-experimental study was to analyze whether the education of radiology personnel mandated by the American Registry of Radiologic Technologists (ARRT) affects the quality of care delivered to radiology patients. One area of radiology quality of care was focused on the findings presented in this study: radiation dosage. Three groups of study participants were used. The participants were chosen and divided into groups based on their radiology background, non-radiology medical background, or lack of medical background. All study participants were required to complete an assessment asking participants what radiation dosage and shields they would use for ...


A Case Series On Uterine Arteriovenous Malformations: A Life-Threatening Emergency In Young Women, Rabia Hammad, Sidrah Nausheen, Mumtaz Malik Jul 2020

A Case Series On Uterine Arteriovenous Malformations: A Life-Threatening Emergency In Young Women, Rabia Hammad, Sidrah Nausheen, Mumtaz Malik

Department of Obstetrics & Gynaecology

Uterine arteriovenous malformation (AVM) is a rare condition, with few cases reported in the literature. Despite being rare, it is a potentially life-threatening condition in women of child-bearing age. It should be considered in the differential diagnosis of prolonged or irregular vaginal bleeding, which, otherwise, can lead to critical complications ending up in severe morbidity and mortality. This case series describes four cases of young Asian women aged between 33 and 38 years who presented with irregular vaginal bleeding. Trans-abdominal ultrasound of the pelvis showed increased vascularity with multi-directional blood flow in the uterus. Magnetic resonance imaging (MRI) confirmed an ...


Evolving Role Of Radiology In Covid-19 Pandemic: A Review, Sarwat Hussain Jul 2020

Evolving Role Of Radiology In Covid-19 Pandemic: A Review, Sarwat Hussain

COVID-19 Publications by UMMS Authors

Background: This worldwide outbreak has disrupted a steady world of healthcare. Until now, diagnostic radiology and laboratory tests had been reasonably accurate in confirmed disease.

Methods: The review article used data bases, published literature, radiological guidelines issued from societies related to COVID-19 and large number of research journals to find out the latest evidence for the evolving role of radiology in COVID-19 pandemic.

Results: Computed Tomography scanning of the lungs demonstrated ground glass grounded opacities (34%) alone or in combination with consolidations (41%). In the first 5 days following exposure the false-negative rate of the RT-PCR testing is as much ...


Perfusion-Guided Sonopermeation Of Neuroblastoma: A Novel Strategy For Monitoring And Predicting Liposomal Doxorubicin Uptake, Aditi Bellary, Arelly Villarreal, Rojin Eslami, Quincy J Undseth, Bianca Lec, Ann M Defnet, Naina Bagrodia, Jessica J Kandel, Mark A Borden, Sumbul Shaikh, Rajiv Chopra, Theodore W Laetsch, Lauren J. Delaney, Colette Shaw, Md, John R. Eisenbrey, Sonia L Hernandez, Shashank R Sirsi Jul 2020

Perfusion-Guided Sonopermeation Of Neuroblastoma: A Novel Strategy For Monitoring And Predicting Liposomal Doxorubicin Uptake, Aditi Bellary, Arelly Villarreal, Rojin Eslami, Quincy J Undseth, Bianca Lec, Ann M Defnet, Naina Bagrodia, Jessica J Kandel, Mark A Borden, Sumbul Shaikh, Rajiv Chopra, Theodore W Laetsch, Lauren J. Delaney, Colette Shaw, Md, John R. Eisenbrey, Sonia L Hernandez, Shashank R Sirsi

Department of Radiology Faculty Papers

Neuroblastoma (NB) is the most common extracranial solid tumor in infants and children, and imposes significant morbidity and mortality in this population. The aggressive chemoradiotherapy required to treat high-risk NB results in survival of less than 50%, yet is associated with significant long-term adverse effects in survivors. Boosting efficacy and reducing morbidity are therefore key goals of treatment for affected children. We hypothesize that these may be achieved by developing strategies that both focus and limit toxic therapies to the region of the tumor. One such strategy is the use of targeted image-guided drug delivery (IGDD), which is growing in ...


Coronary Artery Aneurysm In Kawasaki Disease., Achala Donuru, Maansi Parekh, Vinay V R Kandula, Sharon Gould Jul 2020

Coronary Artery Aneurysm In Kawasaki Disease., Achala Donuru, Maansi Parekh, Vinay V R Kandula, Sharon Gould

Department of Radiology Faculty Papers

A 3-year-old male presents to the emergency department with chief complaints of fever and vomiting. He had a positive rapid streptococcus throat test with cervical lymphadenopathy. The patient was started on antibiotics. On examination, there was diffuse erythematous macular rash on the chest. Laboratory tests revealed elevated white cell count and C-reactive protein. Electrocardiogram was notable for prolonged PR interval indicating 1st degree atrioventricular block. Echocardiogram revealed ectasia of the right coronary artery (RCA). A presumptive diagnosis of Kawasaki disease was made and the patient was started on high-dose aspirin and intravenous immunoglobulins. Cardiac computed tomography angiography (CTA) showed ...


Dosimetric Effect When Treating Multiple Lesion Srs Using Vmat With And Without Jaw Tracking, Mindy Bui Jul 2020

Dosimetric Effect When Treating Multiple Lesion Srs Using Vmat With And Without Jaw Tracking, Mindy Bui

Masters Projects

The main purpose of this study was to determine if jaw tracking or non-jaw tracking is the superior technique for patients with multiple brain metastasis that are treated with Volumetric Modulated Radiation Therapy (VMAT) Stereotactic Radiosurgery (SRS). Doses to the organs at risk (OAR) and the target volumes were analyzed using the dose volume histogram (DVH) and dose statistics for each plan. The goal of this study included analyzing the dosimetric effect on the organs at risk and the normal tissue when using jaw tracking versus non jaw tracking. The pros and cons for each technique were identified as well ...


The Air Gap Effect Between A Bolus And The Skin Surface For Chest Wall Irradiation, Marisa Clark Jul 2020

The Air Gap Effect Between A Bolus And The Skin Surface For Chest Wall Irradiation, Marisa Clark

Masters Projects

Planning technique and bolus choice are important aspects in planning chest wall irradiation (CWI). Many previous studies have tested various combinations of photon energies, electron energies, bolus types and sizes, air gaps sizes, and treatment methods. This study aims to assess the effect of smaller, clinically relevant air gap sizes on specific chest wall treatments using a variety of common bolus types. Due to the Covid-19 pandemic, no data was able to be collected and was instead fabricated by the researcher. Four different treatment plans were created on a phantom patient using various energies of photons (6MV and 10MV) and ...


Dosimetric Comparison Of Hypofractionated Prostate Radiation With Simultaneous Integrated Boost And Conventional Fractionation With Sequential Boost, Kristina Sammon Jul 2020

Dosimetric Comparison Of Hypofractionated Prostate Radiation With Simultaneous Integrated Boost And Conventional Fractionation With Sequential Boost, Kristina Sammon

Masters Projects

Introduction: Hypofractionated treatment delivery regimens are associated with better overall long-term disease control for prostate cancer. For patients with high-risk disease, there may be an indication for treatment of the surrounding pelvic lymph nodes for better over-all disease control. In order to achieve a hypofractionated regimen with treatment to the surrounding pelvic lymph nodes a simultaneous integrated boost technique is employed. There are concerns regarding achievability of target dose coverage and limitation of dose to the surrounding organs at risk with this fractionation.

Methods: This study is a retrospective dosimetric analysis of 7 randomly selected patients with high-risk prostate cancer ...


Diagnostic Radiology In Nigeria: A Country Report, Bukunmi Michael Idowu, Tolulope Adebayo Okedere Jun 2020

Diagnostic Radiology In Nigeria: A Country Report, Bukunmi Michael Idowu, Tolulope Adebayo Okedere

Journal of Global Radiology

Nigeria is located in West Africa. The Nigerian healthcare system is stratified into three tiers corresponding to the three tiers of government: primary (local), secondary (state), and tertiary (federal). In addition to this public health structure, private facilities play a significant role in healthcare delivery. Nigeria has a shortage of healthcare equipment and personnel, with a doctor per 1,000 population ratio of 0.17, which is one of the lowest on the African continent. Despite these challenges, a wide range of medical imaging services is available in the country, through a network of public and private facilities. The public ...


Factors Associated With Mortality After Undergoing Thrombectomy For Acute Ischemic Stroke, Hannah Lin Jun 2020

Factors Associated With Mortality After Undergoing Thrombectomy For Acute Ischemic Stroke, Hannah Lin

GSBS Dissertations and Theses

Background: Mechanical thrombectomy is the gold standard for treating patients with certain acute ischemic stroke (AIS) due to large vessel occlusion (LVO). However, even with major advancements and increasing procedural volumes, acute endovascular therapy remains a high-risk procedure with a considerable 90-day mortality rate, affected by a variety of factors.

Purpose: To investigate various clinical and procedural factors associated with 90-day mortality in patients undergoing mechanical thrombectomy for emergent treatment of AIS and determine which of these factors made unique contributions to post-thrombectomy prognosis.

Methods: We examined a prospective registry of 323 patients treated with endovascular thrombectomy for AIS between ...


Discrimination Of Benign From Malignant Breast Lesions In Dense Breasts With Model-Based Analysis Of Regions-Of-Interest Using Directional Diffusion-Weighted Images., Alan I Penn, Milica Medved, Vandana Dialani, Etta D Pisano, Elodia B Cole, David Brousseau, Gregory S Karczmar, Guimin Gao, Barry D Reich, Hiroyuki Abe Jun 2020

Discrimination Of Benign From Malignant Breast Lesions In Dense Breasts With Model-Based Analysis Of Regions-Of-Interest Using Directional Diffusion-Weighted Images., Alan I Penn, Milica Medved, Vandana Dialani, Etta D Pisano, Elodia B Cole, David Brousseau, Gregory S Karczmar, Guimin Gao, Barry D Reich, Hiroyuki Abe

Articles, Abstracts, and Reports

BACKGROUND: There is an increasing interest in non-contrast-enhanced magnetic resonance imaging (MRI) for detecting and evaluating breast lesions. We present a methodology utilizing lesion core and periphery region of interest (ROI) features derived from directional diffusion-weighted imaging (DWI) data to evaluate performance in discriminating benign from malignant lesions in dense breasts.

METHODS: We accrued 55 dense-breast cases with 69 lesions (31 benign; 38 cancer) at a single institution in a prospective study; cases with ROIs exceeding 7.50 cm

RESULTS: The region-growing algorithm for 3D lesion model generation improved inter-observer variability over hand drawn ROIs (DSC: 0.66 vs 0 ...


Current Concepts Imaging In Covid-19 And The Challenges For Low And Middle Income Countries, Jeffrey B. Mendel, Justine T. Lee, David Rosman Jun 2020

Current Concepts Imaging In Covid-19 And The Challenges For Low And Middle Income Countries, Jeffrey B. Mendel, Justine T. Lee, David Rosman

Journal of Global Radiology

With nearly 3,800,000 cases and 270,000 deaths reported worldwide, COVID-19 is a global pandemic unlike any we have seen in our lifetimes (1). As early as 1995, the WHO was warning of a global infectious disease crisis, citing 30 new infectious diseases emerging in the past 20 years, loss of antibiotic effectiveness, low rates of immunization, poverty, and inadequate investment in public health contributing to the more than 17 million people dying each year from infectious diseases, principally in Low and Middle Income countries (LMIC) (2). Unlike previous infectious diseases, at the time of this writing over ...


Internal Hernia As A Late Complication Of Roux-En-Y Gastric Bypass Procedure, Samantha Purton Omsiii, Gabriel Meshekow Do Mph, My Myers Md, Edgar Mercado Md, Allan Katz Md Jun 2020

Internal Hernia As A Late Complication Of Roux-En-Y Gastric Bypass Procedure, Samantha Purton Omsiii, Gabriel Meshekow Do Mph, My Myers Md, Edgar Mercado Md, Allan Katz Md

West Florida Division Virtual Research Day

As the prevalence of obesity continues to rise, so does the popularity of bariatric surgery. Previously the Roux-en-Y gastric bypass was the most common bariatric procedure, but now falls second to the gastric sleeve. It remains a relevant procedure, however, accounting for 17% of bariatric procedures in 2018. Due to its prevalence, it is important that the radiologist be familiar with the procedure and its complications such as leak, obstruction, stricture, or, as in this case, internal herniation through a mesenteric defect. Internal hernias are more commonly associated with the laparoscopic approach versus open. This is likely due to fewer ...


Labrad : Vol 46, Issue 2 - June 2020, Aga Khan University Hospital, Karachi Jun 2020

Labrad : Vol 46, Issue 2 - June 2020, Aga Khan University Hospital, Karachi

LABRAD

  • Pathophysiology of Lung Injury in Context with Novel Coronavirus 2019
  • Imaging in COVID-19 Pandemic: Salient Features
  • Qualitative Real-Time RT-PCR For Detection of SARS-Cov-2 RNA
  • Coagulopathy and Anticoagulants in COVID-19
  • AKUH Blood Bank During SARS-COV-2 Outbreak
  • Significance of COVID-19 Whole Genome Sequencing
  • Convalescent Plasma Therapy for COVID-19
  • COVID-19: An Alarm Bell for Healthcare System in Pakistan!
  • Emergency Online Undergraduate Medial Education During COVID 19
  • Adopting Virtual Teaching During the Pandemic-An Overview of the Utility of ‘Microsoft Teams’ from an Educator’s Perspectiv
  • The Best of the Recent Past
  • Polaroid


Tumor Boards During Covid-19 Pandemic, Ahmed Nadeem Abbasi Jun 2020

Tumor Boards During Covid-19 Pandemic, Ahmed Nadeem Abbasi

Department of Radiation Oncology

No abstract provided.


Breast Imaging Chameleon: Pseudoangiomatous Stromal Hyperplasia Presenting As Breast Malignancy, Rabail Raza, Kulsoom Fatima, Muhammad Usman Tariq May 2020

Breast Imaging Chameleon: Pseudoangiomatous Stromal Hyperplasia Presenting As Breast Malignancy, Rabail Raza, Kulsoom Fatima, Muhammad Usman Tariq

Department of Radiology

Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal proliferative lesion of the breast, often an incidental finding on breast biopsy specimens and rarely presents as a palpable lump. The case being reported is interesting as a lactating female presented with gross left breast enlargement due to a huge firm mass with skin thickening and palpable left axillary lymph nodes. A provisional diagnosis of left breast malignancy was made and the patient extensively worked up with ultrasound, CT scan, bone scan and core biopsy. The histopathology, however, revealed PASH of the breast. There was no invasive or in situ malignancy. The ...


Outcome Of Non-Malignant Papillary Lesions Of The Breast On Core Biopsy: An Experience From A Tertiary Care Center In Pakistan, Kulsoom Fatima, Shaista Afzal Saeed, Muhammad Usman Tariq May 2020

Outcome Of Non-Malignant Papillary Lesions Of The Breast On Core Biopsy: An Experience From A Tertiary Care Center In Pakistan, Kulsoom Fatima, Shaista Afzal Saeed, Muhammad Usman Tariq

Department of Radiology

Background: Papillary lesions of the breast constitute a heterogeneous group ranging from non-malignant papillomas to papillary carcinoma. While surgical excision is recommended for atypical papilloma or papillary DCIS/ carcinoma on core biopsy, controversy persists in the management of benign papillomas which are diagnosed with core needle biopsy (CNB) since there are variable reported rates for tumor upgrade. The purpose of this study was to determine the outcome of papillary lesions of the breast diagnosed at image-guided CNB, after surgical excision or follow-up, and to identify potential predictors of high-risk lesions/malignancy on imaging.
Materials and methods: We retrospectively identified 52 ...


Risk Factors And The Natural History Of Accelerated Knee Osteoarthritis: A Narrative Review, Jeffrey B. Driban, Matthew S. Harkey, Mary F. Barbe, Robert J. Ward, James W. Mackay, Julie E. Davis, Bing Lu, Lori Lyn Price, Charles B. Eaton, Grace H. Lo, Timothy E. Mcalindon May 2020

Risk Factors And The Natural History Of Accelerated Knee Osteoarthritis: A Narrative Review, Jeffrey B. Driban, Matthew S. Harkey, Mary F. Barbe, Robert J. Ward, James W. Mackay, Julie E. Davis, Bing Lu, Lori Lyn Price, Charles B. Eaton, Grace H. Lo, Timothy E. Mcalindon

Open Access Articles

BACKGROUND: Osteoarthritis is generally a slowly progressive disorder. However, at least 1 in 7 people with incident knee osteoarthritis develop an abrupt progression to advanced-stage radiographic disease, many within 12 months. We summarize what is known - primarily based on findings from the Osteoarthritis Initiative - about the risk factors and natural history of accelerated knee osteoarthritis (AKOA) - defined as a transition from no radiographic knee osteoarthritis to advanced-stage disease < 4 years - and put these findings in context with typical osteoarthritis (slowly progressing disease), aging, prior case reports/series, and relevant animal models. Risk factors in the 2 to 4 years before radiographic manifestation of AKOA (onset) include older age, higher body mass index, altered joint alignment, contralateral osteoarthritis, greater pre-radiographic disease burden (structural, symptoms, and function), or low fasting glucose. One to 2 years before AKOA onset people often exhibit rapid articular cartilage loss, larger bone marrow lesions and effusion-synovitis, more meniscal pathology, slower chair-stand or walking pace, and increased global impact of arthritis than adults with typical knee osteoarthritis. Increased joint symptoms predispose a person to new joint trauma, which for someone who develops AKOA is often characterized by a destabilizing meniscal tear (e.g., radial or root tear). One in 7 people with AKOA onset subsequently receive a knee replacement during a 9-year period. The median time from any increase in radiographic severity to knee replacement is only 2.3 years. Despite some similarities, AKOA is different than other rapidly progressive arthropathies and collapsing these phenomena together or extracting results from one type of osteoarthritis to another should be avoided until further research comparing these types of osteoarthritis is conducted. Animal models that induce meniscal damage in the presence of other risk factors or create an incongruent distribution of loading on joints create an accelerated form of osteoarthritis compared to other models and may offer insights into AKOA.

CONCLUSION: Accelerated knee osteoarthritis is unique from typical knee osteoarthritis. The incidence of AKOA in the Osteoarthritis Initiative and Chingford Study is substantial. AKOA needs to be taken into account and studied ...


Reading Room Assistance Pilot: Improving Radiologist Workflow, Michael Hoy, Md, Christopher G. Roth, Md, Ms-Hqs, Rashmi Balasubramanya, Md May 2020

Reading Room Assistance Pilot: Improving Radiologist Workflow, Michael Hoy, Md, Christopher G. Roth, Md, Ms-Hqs, Rashmi Balasubramanya, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Aims for Improvement

Our aim for improvement was to find ways to decrease distractions and phone calls in the body radiology reading room and to convert unpredictable and “immediate-response distractions” to “managed distractions” that can be addressed without aborting patient care/case interpretation immediately and unnecessarily. The goal was to decrease interruptions which would allow more time to be spent on reading cases, learning, and teaching. One metric that we identified was the number of phone calls to the reading room, which we intend to decrease by 50% within the first quarter. Another metric was the radiology attending and resident ...


Scanning For Qi: Outcomes From A Resident And Sonographer Driven Improvement Of Radiology Resident Ultrasound Technique, Brian Blumhof, Md, Corinne Wessner, Bs, Rdms, Rvt, Kristen Mcclure, Md May 2020

Scanning For Qi: Outcomes From A Resident And Sonographer Driven Improvement Of Radiology Resident Ultrasound Technique, Brian Blumhof, Md, Corinne Wessner, Bs, Rdms, Rvt, Kristen Mcclure, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Objective

The aim of this structural quality improvement (QI) project was to improve the educational ultrasound curriculum.

We created the pilot for an enduring addition to the radiology residency at Jefferson, with plans to include additional ultrasound examinations as the curriculum becomes more robust.

Stakeholders included not only the radiology residency, which would benefit from improved resident education and knowledge, but also the hospital and ultimately patients, who stand to benefit from improved delivery of care.


Improving Primary Prevention Of Coronary Artery Disease In Women Using Breast Arterial Calcifications Seen On Screening Mammography, Rachel Redfield, Md, Sarah Kamel, Md, Rani Rajaram, Md, Kathryn Anderson, Ba, Matthew Metzinger, Mba, Kamini Patel, Bsn, Lydia Liao, Md, Katherine Sherif, Md, Yair Lev, Md May 2020

Improving Primary Prevention Of Coronary Artery Disease In Women Using Breast Arterial Calcifications Seen On Screening Mammography, Rachel Redfield, Md, Sarah Kamel, Md, Rani Rajaram, Md, Kathryn Anderson, Ba, Matthew Metzinger, Mba, Kamini Patel, Bsn, Lydia Liao, Md, Katherine Sherif, Md, Yair Lev, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

Study Aims

  • To create an interdisciplinary task force focused on identifying women with CVD by reporting presence of BAC on screening mammograms.
  • To monitor the clinical impact of reporting BAC.


The Incidence Of Node-Positive Non-Small-Cell Lung Cancer Undergoing Sublobar Resection And The Role Of Radiation In Its Management, John M. Varlotto, Isabel Cristina Martins Emmerick, Debra Maddox, Christine Herbert, Molly Griffin, Paul Rava, Thomas J. Fitzgerald, Paulo Oliveira, Jennifer Baima, Rahul N. Sood, William Walsh, Lacey J. Mcintosh, Feiran Lou, Mark W. Maxfield May 2020

The Incidence Of Node-Positive Non-Small-Cell Lung Cancer Undergoing Sublobar Resection And The Role Of Radiation In Its Management, John M. Varlotto, Isabel Cristina Martins Emmerick, Debra Maddox, Christine Herbert, Molly Griffin, Paul Rava, Thomas J. Fitzgerald, Paulo Oliveira, Jennifer Baima, Rahul N. Sood, William Walsh, Lacey J. Mcintosh, Feiran Lou, Mark W. Maxfield

University of Massachusetts Medical School Faculty Publications

Purpose: To identify the incidence, preoperative risk factors, and prognosis associated with pathologically positive lymph node (pN+) in patients undergoing a sub-lobar resection (SLR).

Methods: This is a retrospective study using the National Cancer Database (NCDB) from 2004 to 2014 analyzing SLR excluding those with any preoperative chemotherapy and/or radiation, follow-up < 3 months, stage IV disease, or > 1 tumor nodule. Multivariable modeling (MVA) was used to determine factors associated with overall survival (OS). Propensity score matching (PSM) was used to determine preoperative risk factors for pN+ in patients having at least one node examined to assess radiation's effect on OS in those patients with ...


Peptic Ulcer Perforation After Cesarean Section; Case Series And Literature Review, Mahboobeh Shirazi, Mehnoosh Tork Zaban, Sriharsha Gummadi, Marjan Ghaemi May 2020

Peptic Ulcer Perforation After Cesarean Section; Case Series And Literature Review, Mahboobeh Shirazi, Mehnoosh Tork Zaban, Sriharsha Gummadi, Marjan Ghaemi

Department of Radiology Faculty Papers

BACKGROUND: Peptic ulcer perforation in the early post-cesarean period is rare but may result in maternal mortality.

CASE PRESENTATION: Four cases of post-cesarean peptic ulcer perforation are presented. In all four patients, presentations include peritoneal signs such as acute abdominal pain and progressive distention, hemodynamic instability and intraperitoneal free fluid by ultrasound. Laparotomy and repair were done in all 4 cases. There were 2 maternal deaths. We also have reviewed English literature for the similar cases reported from 1940 to March 2019.

CONCLUSION: New onset tachycardia, abdominal pain and progressive distension after cesarean section without congruent changes in hemoglobin should ...


Phantoms To Placentas: Mr Methods For Oxygen Quantification, Kelsey Meinerz May 2020

Phantoms To Placentas: Mr Methods For Oxygen Quantification, Kelsey Meinerz

Arts & Sciences Electronic Theses and Dissertations

Molecular oxygen (O2) is vital for efficient energy production and improper oxygenation is a hallmark of disease or metabolic dysfunction. In many pathologies, knowledge of tissue oxygen levels (pO2) could aid in diagnosis and treatment planning. The gold standard for pO2 measures in tissue are implantable probes, which are invasive, require surgery for placement, and are inaccessible to certain regions of the body. Methods for determining pO2 both non-invasively and quantitatively are lacking. The slight paramagnetic nature of O2 provides opportunities to non-invasively characterize pO2 in tissue via magnetic resonance (MR) techniques. As such, O2 can be treated as a ...