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Articles 931 - 960 of 2337

Full-Text Articles in Radiology

Acr Appropriateness Criteria® Staging And Follow-Up Of Primary Vaginal Cancer., Aoife Kilcoyne, Ravi V Gottumukkala, Stella K Kang, Esma A. Akin, Carlin Hauck, Nicole M Hindman, Chenchan Huang, Namita Khanna, Rajmohan Paspulati, Gaiane M Rauch, Tamer Said, Atul B Shinagare, Erica B Stein, Aradhana M Venkatesan, Katherine E Maturen Nov 2021

Acr Appropriateness Criteria® Staging And Follow-Up Of Primary Vaginal Cancer., Aoife Kilcoyne, Ravi V Gottumukkala, Stella K Kang, Esma A. Akin, Carlin Hauck, Nicole M Hindman, Chenchan Huang, Namita Khanna, Rajmohan Paspulati, Gaiane M Rauch, Tamer Said, Atul B Shinagare, Erica B Stein, Aradhana M Venkatesan, Katherine E Maturen

Radiology Faculty Publications

No abstract provided.


The Radiological Presentation Of Rasmussen Aneurysm Secondary To Pulmonary Tuberculosis And Covid-19: A Case Report, Adnan Arif, Khurram Khaliq Bhinder, Azza Sarfraz, Zouina Sarfraz, Miguel Felix, Ivan Chérrez-Ojeda Nov 2021

The Radiological Presentation Of Rasmussen Aneurysm Secondary To Pulmonary Tuberculosis And Covid-19: A Case Report, Adnan Arif, Khurram Khaliq Bhinder, Azza Sarfraz, Zouina Sarfraz, Miguel Felix, Ivan Chérrez-Ojeda

Department of Paediatrics and Child Health

Rasmussen aneurysm is rare diagnosis occurring in patients with long-standing tuberculosis. TB-COVID-19 co-infection in the context of Rasmussen aneurysm is a rare occurrence, yet new cases are emerging. An elderly male was recently diagnosed with TB-COVID-19 co-infection and presented with sudden onset massive hemoptysis. The patient was diagnosed with Rasmussen aneurysm after being evaluated by computed tomography pulmonary angiogram due to a suggestive clinical presentation. Interventional radiologists planned for embolization of pulmonary artery, with an unidentifiable source. It was suspected that the patient's source of bleeding was hampered due to local tamponade effect or thrombosis of the aneurysm. The patient …


Lipomatous Infiltration In Tuberous Sclerosis Complex - A Case Series And Literature Review., Mohammed Ilyas, Julio Quezada, Erin K. Opfer Oct 2021

Lipomatous Infiltration In Tuberous Sclerosis Complex - A Case Series And Literature Review., Mohammed Ilyas, Julio Quezada, Erin K. Opfer

Manuscripts, Articles, Book Chapters and Other Papers

Diffuse Lipomatosis is a dermatological lesion consisting of a poorly circumscribed, infiltrative overgrowth of mature adipose tissue that usually affects the trunk and the extremities. The lesions in the Tuberous Sclerosis Complex (TSC) are usually hamartomatous in nature, but lesions arising from adipocytes are rare. There are only three previous reports of association of TSC with diffuse lipomatosis. Herein we present a case series of diffuse lipomatosis in three subjects with TSC and proceed to review the literature for any other reported cases. On the basis of the three index cases and identification of three more cases in the literature, …


Multipara With Utero-Vesical Fistula Following Repeat Cesarean Section: A Rare Iatrogenic Complication, Gulnaz Shafqat, Anam Khan, Salma Azam, Rehana Murad Oct 2021

Multipara With Utero-Vesical Fistula Following Repeat Cesarean Section: A Rare Iatrogenic Complication, Gulnaz Shafqat, Anam Khan, Salma Azam, Rehana Murad

Department of Radiology

Utero-Vesical fistulas are the rarest of all urogenital fistulas, with most cases occurring after cesarean section. Its prevalence is increasing worldwide because of the increasing indications of cesarean section. Patient usually presents with urine leak, amenorrhea and cyclic hematuria. Herein, we present a case of patient presenting with complain of severe urinary tract infection following cesarean section. Review and update of recent literature regarding the diagnostic imaging of this entity are described.


Hepatocellular Carcinoma With Extrahepatic Blood Supply From Right Renal Artery, Amir Humza Sohail, Ahmad Musa, Muhammad Salman Khan, Hassan Raza Hashmi, Basit Salam, Collin E M. Brathwaite Oct 2021

Hepatocellular Carcinoma With Extrahepatic Blood Supply From Right Renal Artery, Amir Humza Sohail, Ahmad Musa, Muhammad Salman Khan, Hassan Raza Hashmi, Basit Salam, Collin E M. Brathwaite

Department of Radiology

Extrahepatic blood supply is seen in around 17-27% of hepatocellular carcinoma lesions. Evidence suggests that this extrahepatic supply most commonly originates from a right intercostal artery (70-83%) followed by left intercostal, omental and right renal arteries. Thus a comprehensive knowledge of variations in standard vascular anatomy and cognisance of factors influencing or predicting extrahepatic blood supply in HCC is instrumental in ensuring the success of surgical and interventional procedures. We present the unusual case of a 66-year-old male with HCC in Segment I of the liver with aberrant blood supply from the right renal artery in the absence of any …


Diagnostic Accuracy Of Ultrasonography For Rotator Cuff Tears: A Systematic Review And Meta-Analysis, Ali S Farooqi, Alexander Lee, David Novikov, Ann Marie Kelly, Xinning Li, John D Kelly, Robert L Parisien Oct 2021

Diagnostic Accuracy Of Ultrasonography For Rotator Cuff Tears: A Systematic Review And Meta-Analysis, Ali S Farooqi, Alexander Lee, David Novikov, Ann Marie Kelly, Xinning Li, John D Kelly, Robert L Parisien

Department of Medicine Faculty Papers

Background: With recent improvements in transducer strength, image resolution, and operator training, ultrasound (US) provides an excellent alternative imaging modality for the diagnosis of rotator cuff tears.

Purpose: To evaluate the diagnostic accuracy of US for partial- and full-thickness rotator cuff tears and biceps tendon tears, compare diagnostic values with those of magnetic resonance imaging (MRI) using arthroscopy as the reference standard, assess longitudinal improvements in accuracy, and compare diagnostic values from operators with different training backgrounds.

Study Design: Systematic review; Level of evidence, 3.

Methods: The PubMed and Cochrane Library databases were systematically searched for full-text journal articles published …


A Curriculum Model For Multidisciplinary Training Of Midwife Sonographers In A Low Resource Setting, Sudhir Vinayak, Marleen Temmerman, Geert Villeirs, Sharon M. Brownie Oct 2021

A Curriculum Model For Multidisciplinary Training Of Midwife Sonographers In A Low Resource Setting, Sudhir Vinayak, Marleen Temmerman, Geert Villeirs, Sharon M. Brownie

Imaging & Diagnostic Radiology, East Africa

In many low-resource settings, less than 5% of pregnant women can access ultrasound during pregnancy. Thus, gestational age is often difficult to determine, multiple pregnancies are diagnosed late and foetal and pregnancy-related anomalies can go undetected. A pilot solution was designed beyond the traditional approach of increasing numbers of qualified radiologists, gynaecologists and sonographers. An innovative Human Resource for Health (HRH) task sharing, and maternal child health (MCH) workforce training and capacity building initiative was designed, involving development and testing of a curriculum to train midwife sonographers via a teleradiology innovation platform and a partnership between specialist radiologists, sonographers and …


Labrad : Vol 46, Issue 4 - October 2021, Aga Khan University Hospital, Karachi Oct 2021

Labrad : Vol 46, Issue 4 - October 2021, Aga Khan University Hospital, Karachi

LABRAD - Departments of Pathology & Laboratory Medicine and Radiology Archives

  • Role of Barcoding in a Clinical Laboratory to Reduce Pre-Analytical Errors
  • Congenital Dyserythropoietic Anemia: The Morphological Diagnosis
  • Digital Imaging in Hematology: A New Beginning
  • Metabolomics: Identification of Fatty Acid Oxidation (FAO) Disorders
  • Next-Generation Sequencing for HLA Genotyping
  • Urine Metabolomics to identify Organic Academia
  • Next-Generation Sequencing (NGS) of Solid Tumor
  • Importance of using Genomic Tool in Microbial Identification
  • Radiology Practice in 21st Century: Role of Artificial Intelligence
  • Case Quiz
  • Best of the Recent Past
  • Polaroid


Contrast-Enhanced Ultrasound Assessment Of Treatment Response In A Patient With Multifocal Hepatocellular Carcinoma Treated With Transarterial Chemo And Radioembolization, Esika Savsani, M. Tantawi, Corinne Wessner, Philip Lee, Andrej Lyshchik, Kevin Anton, Colette Shaw, Ji-Bin Liu, John R. Eisenbrey Sep 2021

Contrast-Enhanced Ultrasound Assessment Of Treatment Response In A Patient With Multifocal Hepatocellular Carcinoma Treated With Transarterial Chemo And Radioembolization, Esika Savsani, M. Tantawi, Corinne Wessner, Philip Lee, Andrej Lyshchik, Kevin Anton, Colette Shaw, Ji-Bin Liu, John R. Eisenbrey

Department of Radiology Faculty Papers

Minimally invasive locoregional therapies have become important treatment options for patients with intermediate or late-stage hepatocellular carcinoma (HCC) who are ineligible for surgical resection or liver transplantation. Imaging modalities are essential for procedural guidance and for assessing treatment response thereafter. We report a unique finding of a patient with multifocal HCC treated with transarterial radioembolization (TARE) with yttrium-90 (Y90) and transarterial chemoembolization (TACE). We compared contrast-enhanced ultrasound (CEUS) with contrast-enhanced magnetic resonance imaging (CE-MRI) in the evaluation of treatment response to demonstrate advantages of CEUS imaging technique and its early detection of viable tumor.


Point-Of-Care Ultrasound: New Concepts And Future Trends, Yaoting Wang, Huihui Chai, Ruizhong Ye, Jingzhi Li, Ji-Bin Liu, Chen Lin, Chengzhong Peng Sep 2021

Point-Of-Care Ultrasound: New Concepts And Future Trends, Yaoting Wang, Huihui Chai, Ruizhong Ye, Jingzhi Li, Ji-Bin Liu, Chen Lin, Chengzhong Peng

Department of Radiology Faculty Papers

Ultrasound (US) technology, with major advances and new developments, has become an essential and first-line imaging modality for clinical diagnosis and interventional treatment. US imaging has evolved from one-dimensional, twodimensional to three-dimensional display, and from static to real-time imaging, as well as from structural to functional imaging. Based on its portability and advanced digital imaging technique, US was first adopted by emergency medicine in the 1980s and gradually gained popularity among other specialists for clinical diagnosis and interventional treatment. Point-of-Care Ultrasound (POCUS) was then proposed as a new concept and developed for new uses, which greatly extended clinical US applications. …


Stability Of The Sacral Table Angle In Pediatric Patients With Spinal Pathology, David G. Wallington, Patrick D. Albright, Alexandria I. Chrumka, Rebecca D. Funk, Dale E. Rowe, Joseph K. Weistroffer, Karen M. Bovid Sep 2021

Stability Of The Sacral Table Angle In Pediatric Patients With Spinal Pathology, David G. Wallington, Patrick D. Albright, Alexandria I. Chrumka, Rebecca D. Funk, Dale E. Rowe, Joseph K. Weistroffer, Karen M. Bovid

Conference Presentation Abstracts

INTRODUCTION | Pelvic incidence, lumbar lordosis, and pelvisacral angle are common radiographic measures used to evaluate sagittal alignment of the spine and pelvis to assist in clinical decision making. However, the natural history of the sacral table angle (STA) is not well characterized, and there remains uncertainty regarding STA progression over time. Previous studies have established that the STA is stable over time in adult patients, however this question has not been answered for younger patients who have not reached skeletal maturity. In this study, we aim to determine sacral table angle stability over time in a younger patient population. …


Carbon Ion Radiotherapy In The Management Of Hepatocellular Carcinoma, Belal Abousaida, Danushka Seneviratne, Bradford S. Hoppe, Stephen J. Ko, Aroumougame Asaithamby, Francis A. Cucinotta, Jessica M. Kirwan, Kabir Mody, Beau Toskich, Jonathan B. Ashman, Christopher L. Hallemeier, Sunil Krishnan Sep 2021

Carbon Ion Radiotherapy In The Management Of Hepatocellular Carcinoma, Belal Abousaida, Danushka Seneviratne, Bradford S. Hoppe, Stephen J. Ko, Aroumougame Asaithamby, Francis A. Cucinotta, Jessica M. Kirwan, Kabir Mody, Beau Toskich, Jonathan B. Ashman, Christopher L. Hallemeier, Sunil Krishnan

Health Physics and Diagnostic Sciences Faculty Research

Localized hepatocellular carcinoma (HCC) that is unresectable and non-transplantable can be treated by several liver-directed therapies. External beam radiation therapy (EBRT) is an increasingly accepted and widely utilized treatment modality in this setting. Accelerated charged particles such as proton beam therapy (PBT) and carbon ion radiation therapy (CIRT) offer technological advancements over conventional photon radiotherapy. In this review, we summarize the distinct advantages of CIRT use for HCC treatment, focusing on physical and biological attributes, and outline dosimetric and treatment planning caveats. Based on these considerations, we posit that HCC may be among the best indications for use of CIRT, …


Rapid 3d Reconstruction Guided Embolization For Catastrophic Bleeding Following Vacuum Assisted Breast Biopsy; A Case Report And Review Of The Literature, Martin Halicek, Chenghao Qian, Driss Raissi, Xiaoqin Wang, Yevgen Chornenkyy, William B. Bates, Michael Winkler Sep 2021

Rapid 3d Reconstruction Guided Embolization For Catastrophic Bleeding Following Vacuum Assisted Breast Biopsy; A Case Report And Review Of The Literature, Martin Halicek, Chenghao Qian, Driss Raissi, Xiaoqin Wang, Yevgen Chornenkyy, William B. Bates, Michael Winkler

Radiology Faculty Publications

The most clinically significant complication associated with stereotactic core needle biopsy of the breast is hematoma formation, which only occurs in less than 1% of biopsies and may require treatment. Cases of uncontrollable bleeding, refractory to repeated compression, resulting from biopsy are exceedingly rare. We present a case of catastrophic, uncontrollable bleeding and large hematoma formation resulting from stereotactic vacuum-assisted breast biopsy of a breast mass identified in screening mammography. Percutaneous embolization was planned and guided using 3D reconstructions from computed tomographic angiography, and bleeding was successfully controlled with micro-coil embolization.


Comparing Two Methods Of Rectal Diclofenac Administration For Pain Management In Second Trimester Abortion: A Randomized Clinical Trial, Mahboobeh Shirazi, Mehnoosh Torkzaban, Samira Fallah, Marjan Ghaemi Sep 2021

Comparing Two Methods Of Rectal Diclofenac Administration For Pain Management In Second Trimester Abortion: A Randomized Clinical Trial, Mahboobeh Shirazi, Mehnoosh Torkzaban, Samira Fallah, Marjan Ghaemi

Department of Radiology Faculty Papers

Background & Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management in induced second-trimester medical abortion.

Materials & Methods: This randomized clinical trial study was conducted upon pregnant women who were candidates for induced medical abortion and referred to a tertiary educational hospital between October 2019 and December 2020. Participants were divided into two groups based on the mode of diclofenac administration, which was …


Longitudinal Changes Of Regional Myelin Water Fraction During First Year After Moderate-To-Severe Diffuse Traumatic Brain Injury, Likowsky L. Desir Sep 2021

Longitudinal Changes Of Regional Myelin Water Fraction During First Year After Moderate-To-Severe Diffuse Traumatic Brain Injury, Likowsky L. Desir

Dissertations, Theses, and Capstone Projects

Traumatic brain injury (TBI) is a worldwide health issue with a highly heterogeneous disease characterization, including widespread white matter damage in the brain. Most non-invasive white matter imaging methods currently available, including diffusion tensor imaging (DTI), cannot reliably measure the degree of neurodegeneration due to various confounds, making it challenging to select an endpoint measure for neuroprotective clinical trials. The present study investigates longitudinal white matter changes, measured by a novel imaging metric, apparent myelin water fraction (aMWF), and its relationship with neuropsychological measures during the first year after TBI. Data from 15 adult patients with moderate-to-severe TBI and 30 …


Predicting Long-Term Hepatocellular Carcinoma Response To Transarterial Radioembolization Using Contrast-Enhanced Ultrasound: Initial Experiences., Lauren J. Delaney, M. Tantawi, Corinne Wessner, Priscilla Machado, Flemming Forsberg, Andrej Lyshchik, Patrick O'Kane, Ji-Bin Liu, Jesse M. Civan, Alison Tan, Kevin Anton, Colette Shaw, John R. Eisenbrey Sep 2021

Predicting Long-Term Hepatocellular Carcinoma Response To Transarterial Radioembolization Using Contrast-Enhanced Ultrasound: Initial Experiences., Lauren J. Delaney, M. Tantawi, Corinne Wessner, Priscilla Machado, Flemming Forsberg, Andrej Lyshchik, Patrick O'Kane, Ji-Bin Liu, Jesse M. Civan, Alison Tan, Kevin Anton, Colette Shaw, John R. Eisenbrey

Department of Radiology Faculty Papers

Conventional cross-sectional imaging done shortly after radioembolization of hepatocellular carcinoma (HCC) does not reliably predict long-term response to treatment. This study evaluated whether quantitative contrast-enhanced ultrasound (CEUS) can predict the long-term response of HCC to yttrium-90 (Y-90) treatment. Fifteen patients underwent CEUS at three time points: immediately following treatment and 1 and 2 wk post-treatment. Response 3-6 mo after treatment was categorized on contrast-enhanced magnetic resonance imaging by two experienced radiologists using the Modified Response Evaluation Criteria in Solid Tumors. CEUS data were analyzed by quantifying tumor perfusion and residual fractional vascularity using time-intensity curves. Patients with stable disease on …


Diagnosis And Management Of Diffuse Large B-Cell Lymphoma: Society Of Medical Oncology, Pakistan Society Of Hematology, And Pakistan Society Of Clinical Oncology Joint Clinical Practice Guideline, Raheel Iftikhar, Muhammad Ayaz Mir, Munira Moosajee, Kamran Rashid, Syed Waqas Bokhari, Ahmed Nadeem Abbasi, Tahir Sultan Shamsi, Mohammad Usman Shaikh, Natasha Bahadur Ali, Salman Adil Sep 2021

Diagnosis And Management Of Diffuse Large B-Cell Lymphoma: Society Of Medical Oncology, Pakistan Society Of Hematology, And Pakistan Society Of Clinical Oncology Joint Clinical Practice Guideline, Raheel Iftikhar, Muhammad Ayaz Mir, Munira Moosajee, Kamran Rashid, Syed Waqas Bokhari, Ahmed Nadeem Abbasi, Tahir Sultan Shamsi, Mohammad Usman Shaikh, Natasha Bahadur Ali, Salman Adil

Section of Haematology/Oncology

Diffuse large B-cell lymphoma (DLBCL) is the commonest non-Hodgkin lymphoma encountered by hematopathologists and oncologists. Management guidelines for DLBCL are developed and published by countries with high income and do not cater for practical challenges faced in resource-constrained settings. This report by a multidisciplinary panel of experts from Pakistan is on behalf of three major national cancer societies: Society of Medical Oncology Pakistan, Pakistan Society of Hematology, and Pakistan Society of Clinical Oncology. The aim is to develop a practical and standardized guideline for managing DLBCL in Pakistan, keeping in view local challenges, which are similar across most of the …


Aortic Fistulas: Pathophysiologic Features, Imaging Findings, And Diagnostic Pitfalls, Aishwarya Gulati, Md, Harit Kapoor, Md, Achala Donuru, Mbbs, Frcr, Kunal Gala, Mbbs, Dnb, Maansi Parekh, Mbbs, Dnb Sep 2021

Aortic Fistulas: Pathophysiologic Features, Imaging Findings, And Diagnostic Pitfalls, Aishwarya Gulati, Md, Harit Kapoor, Md, Achala Donuru, Mbbs, Frcr, Kunal Gala, Mbbs, Dnb, Maansi Parekh, Mbbs, Dnb

Department of Radiology Faculty Papers

Fistulas between the aorta and surrounding organs are extremely rare but can be fatal if they are not identified and treated promptly. Most of these fistulas are associated with a history of trauma or vascular intervention. However, spontaneous aortic fistulas (AoFs) can develop in patients with weakened vasculature, which can be due to advanced atherosclerotic disease, collagen-vascular disease, vasculitides, and/or hematogenous infections. The clinical features of AoFs are often nonspecific, with patients presenting with bleeding manifestations, back or abdominal pain, fever, and shock. Confirmation with invasive endoscopy is often impractical in the acute setting. Imaging plays an important role in …


Reversing The Effects Of Androgen-Deprivation Therapy In Men With Metastatic Castration-Resistant Prostate Cancer, Catherine H Marshall, Jessa Tunacao, Varun Danda, Hua-Ling Tsai, John Barber, Rakhee Gawande, Clifford R Weiss, Samuel R Denmeade, Corinne Joshu Sep 2021

Reversing The Effects Of Androgen-Deprivation Therapy In Men With Metastatic Castration-Resistant Prostate Cancer, Catherine H Marshall, Jessa Tunacao, Varun Danda, Hua-Ling Tsai, John Barber, Rakhee Gawande, Clifford R Weiss, Samuel R Denmeade, Corinne Joshu

Department of Medical Oncology Faculty Papers

OBJECTIVE: To investigate whether bipolar androgen therapy (BAT), involving rapid cyclic administration of high-dose testosterone, as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) promotes improvements in body composition and associated improvements in lipid profiles and quality of life.

PATIENTS AND METHODS: Men from two completed trials with computed tomography imaging at baseline and after three cycles of BAT were included. Cross-sectional areas of psoas muscle, visceral and subcutaneous fat were measured at the L3 vertebral level. Functional Assessment of Chronic Illness Therapy - Fatigue questionnaire and 36-item short-form health survey were used to assess quality of life.

RESULTS: …


Are Body Surface Area Based Estimates Of Liver Volume Applicable To Children With Overweight Or Obesity? An In Vivo Validation Study., Chelsea Hosey-Cojocari, Sherwin S. Chan, Chance S. Friesen, Amie L. Robinson, Veronica Williams, Erica Swanson, Daniel O'Toole, Jansynn Radford, Neil J. Mardis, Trevor N. Johnson, J Steven Leeder, Valentina Shakhnovich Sep 2021

Are Body Surface Area Based Estimates Of Liver Volume Applicable To Children With Overweight Or Obesity? An In Vivo Validation Study., Chelsea Hosey-Cojocari, Sherwin S. Chan, Chance S. Friesen, Amie L. Robinson, Veronica Williams, Erica Swanson, Daniel O'Toole, Jansynn Radford, Neil J. Mardis, Trevor N. Johnson, J Steven Leeder, Valentina Shakhnovich

Manuscripts, Articles, Book Chapters and Other Papers

The liver is the primary organ responsible for clearing most drugs from the body and thus determines systemic drug concentrations over time. Drug clearance by the liver appears to be directly related to organ size. In children, organ size changes as children age and grow. Liver volume has been correlated with body surface area (BSA) in healthy children and adults and has been estimated by functions of BSA. However, these relationships were derived from "typical" populations and it is unknown whether they extend to estimations of liver volumes for population "outliers," such as children with overweight or obesity, who today …


Medical Imaging Stewardship And Healthcare Savings: Utilization Of Age Adjusted D-Dimer To Rule Out Acute Pulmonary Embolism, Phillip Bloodworth, Casey Morris, Kenneth Cail, Brian L. Pando, Brian Helmly Aug 2021

Medical Imaging Stewardship And Healthcare Savings: Utilization Of Age Adjusted D-Dimer To Rule Out Acute Pulmonary Embolism, Phillip Bloodworth, Casey Morris, Kenneth Cail, Brian L. Pando, Brian Helmly

HCA Healthcare Journal of Medicine

Introduction

Acute pulmonary embolism (PE) is a common diagnosis that can lead to death if left untreated. Computerized tomography pulmonary angiogram scan (CTPA) is the gold standard for diagnosis of PE. Utilization of CTPA is increasing in the emergency setting even when suspicion for PE is very low. While CTPA is helpful, radiation exposure, contrast reactions, and cost must be considered. D-dimer is a well-established, high sensitivity and low specificity laboratory test that can effectively rule out PE in low-risk patients when negative. The ADJUST-PE trial showed that there is a natural rise of D-dimer levels with age. This age …


Intra-Arterial Combination Therapy For Experimental Acute Ischemic Stroke, Michael E. Maniskas, Jill M. Roberts, Amanda A. Gorman, Gregory J. Bix, Justin F. Fraser Aug 2021

Intra-Arterial Combination Therapy For Experimental Acute Ischemic Stroke, Michael E. Maniskas, Jill M. Roberts, Amanda A. Gorman, Gregory J. Bix, Justin F. Fraser

Neurosurgery Faculty Publications

Acute ischemic stroke continues to devastate millions of individuals worldwide. Current treatments work to restore blood flow but not rescue affected tissue. Our goal was to develop a combination of neuroprotective agents administered intra-arterially following recanalization to target ischemic tissue. Using C57Bl/6J male mice, we performed tandem transient ipsilateral middle cerebral/common carotid artery occlusion, followed by immediate intra-arterial pharmacotherapy administration through a standardized protocol. Two pharmacotherapy agents, verapamil and lubeluzole, were selected based on their potential to modulate different aspects of the ischemic cascade; verapamil, a calcium channel blocker, works in an acute fashion blocking L-type calcium channels, whereas lubeluzole, …


Implementing A Clinical Practice Guideline For Pediatric Appendicitis Safely Reduced Health Care Use And Improved Antimicrobial Stewardship, Jack Vernamonti, Robin Cotter, Jennifer Jubulis, Kartikey Pandya Aug 2021

Implementing A Clinical Practice Guideline For Pediatric Appendicitis Safely Reduced Health Care Use And Improved Antimicrobial Stewardship, Jack Vernamonti, Robin Cotter, Jennifer Jubulis, Kartikey Pandya

Journal of Maine Medical Center

Introduction: Appendicitis is the most common emergency surgical disease in children. Those with perforated appendicitis have a more complicated and varied course. Through a clinical practice guideline (CPG), we sought to reduce computed tomography scans, laboratory draws, and exposure to broad-spectrum antibiotics without adversely affecting length of stay, hospital readmission, or repeat antibiotic administration.

Methods: Electronic records were retrospectively reviewed before and after CPG implementation, and data was collected in REDCap.

Results were reported as mean or percent incidence, and statistical analysis was done using a Student’s t-test, Mann-Whitney U test, or Pearson’s χ2 with P < .05 considered significant. Results: One hundred patients with a perforated appendix (50 before and 50 after CPG implementation) were included in our analysis. Length of stay (4.98 vs 4.46 days; P = .25), hospital readmission rate (10% vs 14%; P = .54), and additional antibiotic administration (2% vs 4%; P = .56) did not change. We observed no difference in the Pediatric Appendicitis Score (9 vs 9; P = .48) and a trending increase in evaluation at an outside hospital (56% vs 74%; P = .06). Rates of computed tomography scans did not differ overall (50% vs 40%; P = .31), but showed a decreasing trend at our institution (30% vs 12%; P = .06). We also found fewer post-operative laboratory studies (90% vs 38%; P < .01) and patients who received broad-spectrum intravenous antibiotics (92% vs 18%; P < .01).

Discussion: Through implementing the …


Sonogames: Sounds Of The Right Kind Introducing Gamification Into Radiology Training, Maria Fatima Ali, Naila Nadeem, Farah Khalid, Naveed Muhammad Anwar, Ghulam Nabie, Charles Docherty Aug 2021

Sonogames: Sounds Of The Right Kind Introducing Gamification Into Radiology Training, Maria Fatima Ali, Naila Nadeem, Farah Khalid, Naveed Muhammad Anwar, Ghulam Nabie, Charles Docherty

Centre for Innovation in Medical Education

Background: Radiology as compared to other fields of medicine has lagged, in incorporating modern training modalities such as gamification and simulation into its teaching curriculum.
Objective: This study aims to evaluate effectiveness of simulation-based teaching in collaboration with gamification. Bandura's conception of self-efficacy was used to provide qualitative assessment of participants' learning process through training event. Modified competitive game-based teaching methodology was utilized in an experimental study conducted for radiology residents. Workshop was divided into two sessions, first being three interactive didactic lectures followed by three competitive rounds. All participants were required to fill pre and post-self-efficacy questionnaire along with …


The Transitional Year Internship: Five Classes Of Former Interns Reflect On Their First Clinical Year, Hana L. Haver, Kush K. Patel, Robert Chow Aug 2021

The Transitional Year Internship: Five Classes Of Former Interns Reflect On Their First Clinical Year, Hana L. Haver, Kush K. Patel, Robert Chow

Advances in Clinical Medical Research and Healthcare Delivery

Objective:

The clinical internship (postgraduate year-1), which precedes many advanced residency training programs, are traditionally fulfilled by a transitional year (TY) or preliminary year of training in medicine or surgery. TY programs can take place in a variety of settings, ranging from community hospitals to large academic medical centers. In the present study, we sought to evaluate if resident physicians who completed a community hospital-based TY internship felt prepared for their subsequent specialty residency training.

Methods:

A cross-sectional survey was adapted and distributed to resident physicians who completed their TY internship at a university-affiliated community hospital in Baltimore, Maryland, between …


Gamma Knife Radiosurgery To Four Brainstem Lesions After Whole Brain Radiation Therapy, Mark E. Bernard, William St. Clair, Damodar Pokhrel Aug 2021

Gamma Knife Radiosurgery To Four Brainstem Lesions After Whole Brain Radiation Therapy, Mark E. Bernard, William St. Clair, Damodar Pokhrel

Radiation Medicine Faculty Publications

Our patient was a 58-year-old female with a history of extensive stage small cell lung cancer initially diagnosed in November 2018. She received palliative radiation to the right hip and whole brain in December of 2018 and then received chemotherapy. Unfortunately, in October 2019, the repeat brain magnetic resonance imaging (MRI) showed recurrent lesions and she was referred for Gamma Knife Radiosurgery (GKRS). At the time of the treatment, she was found to have four brainstem lesions as well as a left frontal lobe and a right frontal lobe lesion. She completed GKRS to all six lesions without any neurological …


From Mathematics To Medicine: A Practical Primer On Topological Data Analysis (Tda) And The Development Of Related Analytic Tools For The Functional Discovery Of Latent Structure In Fmri Data, Andrew Salch, Adam Regalski, Hassan Abdallah, Raviteja Suryadevara, Michael J. Catanzaro, Vaibhav A. Diwadkar Aug 2021

From Mathematics To Medicine: A Practical Primer On Topological Data Analysis (Tda) And The Development Of Related Analytic Tools For The Functional Discovery Of Latent Structure In Fmri Data, Andrew Salch, Adam Regalski, Hassan Abdallah, Raviteja Suryadevara, Michael J. Catanzaro, Vaibhav A. Diwadkar

Mathematics Faculty Research Publications

fMRI is the preeminent method for collecting signals from the human brain in vivo, for using these signals in the service of functional discovery, and relating these discoveries to anatomical structure. Numerous computational and mathematical techniques have been deployed to extract information from the fMRI signal. Yet, the application of Topological Data Analyses (TDA) remain limited to certain sub-areas such as connectomics (that is, with summarized versions of fMRI data). While connectomics is a natural and important area of application of TDA, applications of TDA in the service of extracting structure from the (non-summarized) fMRI data itself are heretofore nonexistent. …


Hospital-Based Ultra-Sonographic Prevalence And Spectrum Of Thyroid Incidentalomas In Pakistani Population, Faheem Ullah Khan, Kiran Hilal, Iftikhar Ali, Mehreen Samad, Rabiya Tariq, Wiqar Ahmad, Muhammad Arif Saeed, Noman Khan Aug 2021

Hospital-Based Ultra-Sonographic Prevalence And Spectrum Of Thyroid Incidentalomas In Pakistani Population, Faheem Ullah Khan, Kiran Hilal, Iftikhar Ali, Mehreen Samad, Rabiya Tariq, Wiqar Ahmad, Muhammad Arif Saeed, Noman Khan

Department of Radiology

Introduction: Thyroid incidentalomas (TIs) are clinically asymptomatic nodules found accidentally during imaging studies ordered for some other reasons. Being easily accessible, non-invasive, and inexpensive, thyroid ultrasound (US) is a key investigation in the management of thyroid nodules.
Methods: This ultrasound-based cross-sectional study was performed in the radiology department of a major tertiary care hospital. Every second patient visiting the emergency department was a potential candidate for a thyroid ultrasound. Patients having ages greater than 20 years were included in the study.
Results: A total of 250 patients were included in the study. Out of these, 175 were female and 75 …


Validating Deep Learning Inference During Chest X-Ray Classification For Covid-19 Screening., Robbie Sadre, Baskaran Sundaram, Sharmila Majumdar, Daniela Ushizima Aug 2021

Validating Deep Learning Inference During Chest X-Ray Classification For Covid-19 Screening., Robbie Sadre, Baskaran Sundaram, Sharmila Majumdar, Daniela Ushizima

Department of Radiology Faculty Papers

The new coronavirus unleashed a worldwide pandemic in early 2020, and a fatality rate several times that of the flu. As the number of infections soared, and capabilities for testing lagged behind, chest X-ray (CXR) imaging became more relevant in the early diagnosis and treatment planning for patients with suspected or confirmed COVID-19 infection. In a few weeks, proposed new methods for lung screening using deep learning rapidly appeared, while quality assurance discussions lagged behind. This paper proposes a set of protocols to validate deep learning algorithms, including our ROI Hide-and-Seek protocol, which emphasizes or hides key regions of interest …


Primary Leiomyosarcoma Of The Distal Tibia: A Case Report., Sachin Dheer, Pamela Gekas, Faith Schick, Homyar Karanjia, Nicholas Taweel Aug 2021

Primary Leiomyosarcoma Of The Distal Tibia: A Case Report., Sachin Dheer, Pamela Gekas, Faith Schick, Homyar Karanjia, Nicholas Taweel

Department of Radiology Faculty Papers

The authors present an unusual case of a leiomyosarcoma of the distal tibia. Leiomyosarcoma tumors typically originate from smooth muscle tissue. It is rare for it to derive from bone and even rarer to be found in a bone of the lower limb. Given this extreme rarity in addition to nonspecific findings on plain film radiographs and magnetic resonance imaging (MRI), biopsy was needed in this case. It was only through immunochemistry staining that a definitive diagnosis was made. As such, this case is an illustrative example of an aggressive, though rare, primary lesion of the bone which should be …