bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Prognosis of Plantar Fasciitis: A 5- to 15-Year Follow-up Study of 174 Patients With Ultrasound Examination
Authors: Hansen Liselotte , Krogh Thøger Persson , Ellingsen Torkell , Bolvig Lars , Fredberg Ulrich
Published: March 2018

Background:

Plantar fasciitis (PF) affects 7% to 10% of the population. The long-term prognosis is unknown.

Purpose:

Our study had 4 aims: (1) to assess the long-term prognosis of PF, (2) to evaluate whether baseline characteristics (sex, body mass index, age, smoking status, physical work, exercise-induced symptoms, bilateral heel pain, fascia thickness, and presence of a heel spur) could predict long-term outcomes, (3) to assess the long-term ultrasound (US) development in the fascia, and (4) to assess whether US-guided corticosteroid injections induce atrophy of the heel fat pad.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

From 2001 to 2011 (baseline), 269 patients were diagnosed with PF based on symptoms and US. At follow-up (2016), all patients were invited to an interview regarding their medical history and for clinical and US re-examinations. Kaplan-Meier survival estimates were used to estimate the long-term prognosis, and a multiple Cox regression analysis was used for the prediction model.

Results:

In all, 174 patients (91 women, 83 men) participated in the study. All were interviewed, and 137 underwent a US examination. The mean follow-up was 9.7 years from the onset of symptoms and 8.9 years from baseline. At follow-up, 54% of patients were asymptomatic (mean duration of symptoms, 725 days), and 46% still had symptoms. The risk of having PF was 80.5% after 1 year, 50.0% after 5 years, 45.6% after 10 years, and 44.0% after 15 years from the onset of symptoms. The risk was significantly greater for women ( P < .01) and patients with bilateral pain ( P < .01). Fascia thickness decreased significantly in both the asymptomatic and symptomatic groups ( P < .01) from 6.9 mm and 6.7 mm, respectively, to 4.3 mm in both groups. Fascia thickness ( P = .49) and presence of a heel spur ( P = .88) at baseline had no impact on prognosis. At follow-up, fascia thickness and echogenicity had normalized in only 24% of the asymptomatic group. The mean fat pad thickness was 9.0 mm in patients who had received a US-guided corticosteroid injection and 9.4 mm in those who had not been given an injection ( P = .66).

Conclusion:

The risk of having PF in this study was 45.6% at a mean 10 years after the onset of symptoms. The asymptomatic patients had PF for a mean 725 days. The prognosis was significantly worse for women and patients with bilateral pain. Fascia thickness decreased over time regardless of symptoms and had no impact on prognosis, and neither did the presence of a heel spur. Only 24% of asymptomatic patients had a normal fascia on US at long-term follow-up. A US-guided corticosteroid injection did not cause atrophy of the heel fat pad. Our observational study did not allow us to determine the efficacy of different treatment strategies.
Public Heritage Communication on American Indian Wars Sites: Policy Improvement and Remaining Challenges
Authors: Cho Hyojung , Gendron Ernest
Published: March 2018

Federal historic preservation is an important way to provide public recognition and to promote heritage that was selected by the government for the nation. The history of (American) Indian policies shows an arduous relationship between the US government and American Indians. In spite of the evolution of federal preservation efforts and the federal government’s public heritage communication, Indian heritage sites still reflect the authoritarian and utilitarian understanding towards the Indian heritage. This research studies the US federal government’s understanding of Indian Wars sites through the analysis of interpretation at the Washita Battlefield National Historic Site, which reveals the historically dual approaches towards Indian heritage conservation and the persistent tendency of limited under-standing for American history in the larger social and political arenas despite policy improvement. American Indian battlefields have been neglected in orthodox preservation considering their insufficient value to qualify for patriotic military history preservation or Indian relics preservation. The analysis of preservation efforts and interpretation of Indian Wars sites indicates the evolution of controlling (American) Indian heritage through policy changes and the assessment of policy implementation.
Exploring Training Factors as Incentive Tools in Safeguarding Cultural Heritage of Malaysian Traditional Settlements
Authors: Radzuan Indera Syahrul Mat , Mansir Dodo , Ahmad Yahaya
Published: March 2018

Training and education has become one of the key aspects in improving incentives programme, thus leading to improved cultural heritage preservation within heritage sites. The study investigated the relationship between the importance of training as a tool on incentivizing cultural heritage in selected traditional settlements in Malaysia. Data were collected through a survey from a total of 63 respondents in both Morten and Chitty Village situated at Melaka Historic City and was analysed using IBM SPSS Statistics 23.0 by means of running an exploratory factor analysis (EFA). The 10 indicator items studied for tangible heritage training have satisfactory factor loadings ranging from 0.59 to 0.77 and distribute across 2 extracted factors having satisfactory cumulative variance of 58.36 per cent. Furthermore, the themes of the distributed indicator items enabled the labelling of the 2 extracted factors to being ‘soft skills’ and ‘hard skills’ for tangible heritage training. Similarly, the 9 indicator items studied for intangible heritage training have satisfactory factor loadings ranging from 0.41 to 0.90 and distribute across 2 extracted factors having a satisfactory cumulative variance of 64.42 per cent. Furthermore, the themes of the distributed indicator items across the 2 extracted factors enabled the labelling of the factors to being ‘intangible arts’ and ‘legislation’ for intangible heritage training. These results found that the ‘explored’ indicator items are fit to be used in further structurally modelling both tangible and intangible heritage training as non-financial incentives in sustainably preserving traditional settlements. The implication of this research is its serving as an information support tool for such intended modelling purpose.
Development of a Radiation Oncology–Specific Prospective Data Registry for Research and Quality Improvement: A Clinical Workflow-Based Solution
Authors: Chen Allen M. , Kupelian Patrick A. , Wang Pin-Cheih , Steinberg Michael L.
Published: March 2018

Purpose

The computerized paperless medical recording system has transformed the modern health information system and serves as an idea platform for registry development, particularly in a specialty such as radiation oncology, where technologic advances continue to generate unprecedented amounts of complex data. We present our single-institution experience with the development of a real-time observational registry fully integrated into the process of routine clinical workflow and show how this has the potential to transform research and quality assurance.

Materials and Methods

From May 2011 to May 2016, physicians prospectively inputted data during the process of routine charting on patients seen in clinic. Using a customized interface established between an in-house registry and a commercially available, hospital-based electronic medical record system (Epic Systems, Verona, WI), a departmentally based parser was created for automatic data deposition, which was also linked to the Aria Treatment Planning Station (Varian Medical Systems, Palo Alto, CA). The total number of data fields embedded per disease site ranged from nine to 73 (median, 21 fields).

Results

A total of 12,341 patients were logged into the registry, of whom 6,911 completed a course of radiation therapy. Primary disease sites were prostate (n = 2,340), breast (n = 2,159), head or neck (n = 1,426), primary CNS (n = 1,338), lung (n = 749), brain metastasis (n = 739), GI (n = 638), gynecologic (n = 534), and other or benign (n = 3,618). A total of 54 independent, investigator-initiated research studies have been initiated using queries supported by the registry from multiple access points, of which 23 were published in peer-reviewed journals.

Conclusion

The development of a radiation oncology–specific registry enhanced research efficiency and facilitated quality assurance by producing clear and quality information to guide clinical practice.
Policy Analysis in Government and Academia: Two Cultures
Authors: Glied Sherry
Published: March 2018

Despite concerns that the health policy academy is divorced from policy making, the articles in this special issue generally suggest that academic policy research played important roles in the development, implementation, and subsequent defense of the Affordable Care Act. One reason for this relative success was the presence of many “embedded academics”—researchers who took leaves from universities to spend time working for the Obama administration or Congress. Embedded academics can help bridge the wide gap between the institutional cultures of the academy and of government and can thus act as translators of academic research for policy-making purposes. This essay describes how the cultures of the academy and of government policy research differ and suggests ways to use those cultural differences to improve knowledge translation.
Safety of Prasugrel loading in ruptured blister like aneurysm treated with a Pipeline device
Authors: Parthasarathy Rajsrinivas , Gupta Vipul , Gupta Aditya
Published: March 2018

Objective:

Blister like aneurysm (BLA) is extremely challenging to treat; endoluminal reconstruction has emerged as the most promising treatment method. When to treat after the ictus, the timing of administration of antiplatelet and causal relationship between platelet function testing results and thrombo-embolism is unclear. We theorized that Prasugrel with a lower incidence of resistance may be a safe suitable alternative to clopidogrel in patients treated with a flow diverter (FD).

Methods:

Prospectively collected data from consecutive patients treated for a ruptured blister with an FD was reviewed. Device deployment was timed to be at 2 h following Prasugrel loading. Thrombo-embolic and hemorrhagic complications, and occlusion rates were documented.

Results:

Nine patients were included. Most were females (55%); the median age was 55 (43, 65). The median Fischer grade was 3 (2, 4). A single pipeline device was deployed in all within 24 h of admission; the median time from ictus to device deployment was 4 days (2, 30). There were no thrombo-embolic or hemorrhagic complication. Complete occlusion was noted in 89% (n = 9).

Conclusion:

Prasugrel loading timed 2 h prior to stent delivery did not increase thrombo-embolic or hemorrhagic complications. Single stent that is well apposed against the wall appears to be an effective treatment strategy to treat BLA.

Advances in knowledge:

Treatment of acutely ruptured BLA with a single pipeline device deployed at 2 h after Prasugrel loading appears to be safe.
Postnatal Evaluation of Congenital Chest Pathologies Using a Low-Dose Computed Tomography (CT) Protocol – a Pictorial Review
Authors: Roik Danuta , Barczuk Marzena , Burzyńska Zofia , Biejat Agnieszka , Żerańska Maria , Mierzewska-Schmidt Magdalena , Floriańczyk Tomasz , Brzewski Michał
Published: March 2018

Computed tomography with its excellent spatial and temporal resolution remains a valuable diagnostic modality in pediatrics. On the other hand an increasing attention has been placed on the radiation risks associated with CT imaging, especially in children. In recent years, many advances in CT hardware and software, for example, automatic exposure control tools and iterative reconstruction techniques, have allowed for a reduction of applied radiation doses while maintaining image quality. The purpose of this paper is to present our protocol for chest CT imaging in the youngest age group, together with a pictorial review of congenital pathologies of the chest, and to emphasize factors that optimize postnatal CT imaging in infants. In our opinion, modern CT imaging with the use of dose reduction techniques and iterative reconstructions allows for a proper visualization of chest pathologies in small children, which has no influence on observer performance. The presented review of low-dose diagnostic images of a wide spectrum of congenital pathologies may serve as an example of routine utilization of the current concepts in pediatric CT optimization.
Creating Order Out of Chaos – Role of Antenatal Ultrasound in Diagnosis
Authors: Dethe Vaibhav , Lamghare Purnachandra , Bagale Sachin , Agarwal Vasudha
Published: March 2018

Background: Congenital high airway obstruction syndrome (CHAOS) is a rare fetal anomaly characterized by obstruction of the higher fetal airway. This could be either complete or incomplete and is more commonly seen at the subglottic level, resulting in a spectrum of characteristic secondary features.

Case Report: In this case study, we report two cases of CHAOS with one showing laryngeal atresia and the other, tracheal atresia. Both these cases showed characteristic findings on a detailed, meticulous USG examination which led to this diagnosis.

Conclusions: Early and accurate diagnosis offers a window of opportunity for parental counseling and management using procedures such as EXIT (ex-utero intrapartum procedure). Earlier, CHAOS was thought to be incompatible with life; however, with the advent of ex-utero intrapartum procedure, a few cases of post-natal survival have been noted in the literature. In this article, we emphasize the sonographic findings found in CHAOS. Early diagnosis offers an opportunity for a intrauterine fetal intervention in potentially lethal cases.
Chronically Discharging Ears: Evalution with High Resolution Computed Tomography
Authors: Bhalla Ashu Seith , Singh Anuradha , Jana Manisha
Published: March 2018

Chronic suppurative otitis media (CSOM) refers to the middle ear inflammation which is clinically characterized by the discharging ear, hearing deficit, fever and otalgia. Although a clinical diagnosis, imaging is imperative to rule out associated complications which apart from causing hearing deficit, may prove fatal at times. Both high resolution computed tomography (HRCT) and MRI are helpful in evaluating middle ear pathologies, usage being indication specific. Due to its excellent spatial resolution, HRCT is invaluable in assessment of chronically discharging ears, especially to look for bone erosion and the integrity of the ossicles. Due to its better spatial resolution, HRCT is preferred in suspected intra temporal complications whereas MRI is more useful in evaluating intracranial extension.
Impact of Window Computed Tomography (CT) Parameters on Measurement of Inflammatory Changes in Paranasal Sinuses
Authors: Cebula Maciej , Danielak-Nowak Monika , Modlińska Sandra
Published: March 2018

Background: In accordance with the European guidelines on rhinosinusitis and nasal polyps (EPOS 2012), CT is used as the main imaging modality for the assessment intensity of inflammatory lesions. The aim of this study was to measure the differences in the assessment of inflammatory changes in the paranasal sinuses due to different parameters of width (W) and length (L) of the CT window.

Material/Methods: A retrospective analysis included 44 CT scans of the paranasal sinuses that were performed in adults. All studies were characterized by the presence of inflammatory changes in at least one of the sinuses. Measurements of the same inflammatory lesions were performed sequentially with different CT windows. The results were statistically analyzed.

Results: A statistically significant difference was observed between the average measurements that were performed with the use CT windows dedicated for the sinuses and head. A downward trend in the measured values and a shift towards soft tissue values was observed with decreasing window parameters.

Conclusions: A major cause of inaccurate examinations of pathological changes in the paranasal sinuses may be due to selection of unsuitable CT windows. Therefore, in order to avoid missing inflammatory lesions in the paranasal sinuses, it is reasonable to use CT windows dedicated for the sinuses or bones.
Cerebral Metastases of Lung Cancer Mimicking Multiple Ischaemic Lesions – A Case Report and Review of Literature
Authors: Zacharzewska-Gondek Anna , Maksymowicz Hanna , Szymczyk Małgorzata , Sąsiadek Marek , Bladowska Joanna
Published: March 2018

Background: Restricted diffusion that is found on magnetic resonance diffusion-weighted imaging (DWI) typically indicates acute ischaemic stroke. However, restricted diffusion can also occur in other diseases, like metastatic brain tumours, which we describe in this case report.

Case Report: A 57-year-old male, with a diagnosis of small-cell cancer of the right lung (microcellular anaplastic carcinoma), was admitted with focal neurological symptoms. Initial brain MRI revealed multiple, disseminated lesions that were hyperintense on T2-weighted images and did not enhance after contrast administration; notably, some lesions manifested restricted diffusion on DWI images. Based on these findings, disseminated ischaemic lesions were diagnosed. On follow-up MRI that was performed after 2 weeks, we observed enlargement of the lesions; there were multiple, disseminated, sharply outlined, contrast-enhancing, oval foci with persistent restriction of diffusion. We diagnosed the lesions as disseminated brain metastases due to lung cancer. To our knowledge, this is the first description of a patient with brain metastases that were characterised by restricted diffusion and no contrast enhancement.

Conclusions: Multiple, disseminated brain lesions, that are characterised by restricted diffusion on DWI, typically indicate acute or hyperacute ischemic infarcts; however, they can also be due to hypercellular metastases, even if no contrast enhancement is observed. This latter possibility should be considered particularly in patients with cancer.
Diagnosis of Acute Appendicitis Using Clinical Alvarado Scoring System and Computed Tomography (CT) Criteria in Patients Attending Gujarat Adani Institute of Medical Science – A Retrospective Study
Authors: Vaghela Krishnkant , Shah Bhaven
Published: March 2018

Background:  The aim was to evaluate the clinical Alvarado scoring system and computed tomography (CT) criteria for the diagnosis of acute appendicitis.

Material/Methods: The study was carried out retrospectively in patients who were referred to the Institute between March 2014 and January 2015. One hundred seventeen patients with acute abdominal pain who underwent abdominal CT were enrolled in this retrospective study. Patient demographics, clinical Alvarado scoring, CT images, and pathologic results of the patients were evaluated.

Results:  Thirty nine of the 53 patients who were operated on had pathologically proven acute appendicitis. CT criteria of appendiceal diameter, presence of periappendiceal inflammation, fluid, appendicoliths, and white blood cell count (WBC) were significantly correlated with the inflammation of the appendix. The optimal cut-off value of the appendiceal diameter was 6.5 mm. The correlation between appendiceal diameter and WBC was 80% (P=0.01 <0.05). The correlation between appendiceal diameter and Alvarado score was 78.7% (P=0.01 <0.05).

Conclusions: Presence of appendiceal diameter above 6.5 mm on CT, periappendiceal inflammation, fluid, and appendicoliths should prompt the diagnosis of acute appendicitis. Since patients with acute appendicitis may not always show the typical signs and symptoms, CT is a helpful imaging modality for patients with relatively low Alvarado scores and leukocytosis, when physical examination is confusing.
Correlation Between Findings of Multislice Helical Computed Tomography (CT), Endoscopic Examinations, Endovascular Procedures, and Surgery in Patients with Symptoms of Acute Gastrointestinal Bleeding
Authors: Konecki Dariusz , Grabowska-Derlatka Laretta , Pacho Ryszard , Rowiński Olgierd
Published: March 2018

Background: Endoscopic methods (gastroscopy and colonoscopy) are considered fundamental for the diagnosis of gastrointestinal bleeding. In recent years, multidetector computed tomography (MDCT) has also gained importance in diagnosing gastrointestinal bleeding, particularly in hemodynamically unstable patients and in cases with suspected lower gastrointestinal tract bleeding. CT can detect both the source and the cause of active gastrointestinal bleeding, thereby expediting treatment initiation.

Material/Methods: The study group consisted of 16 patients with clinical symptoms of gastrointestinal bleeding in whom features of active bleeding were observed on CT. In all patients, bleeding was verified by means of other methods such as endoscopic examinations, endovascular procedures, or surgery.

Results: The bleeding source was identified on CT in all 16 patients. In 14 cases (87.5%), bleeding was confirmed by other methods.

Conclusions: CT is an efficient, fast, and readily available tool for detecting the location of acute gastrointestinal bleeding.
Radiation Dose Associated with Multi-Detector 64-Slice Computed Tomography Brain Examinations in Khartoum State, Sudan
Authors: Elmahdi Ali , Abuzaid Mohamed M. , Babikir Esameldeen , Sulieman Abdelmoneim
Published: March 2018

Background: Radiation exposure due to computed tomography (CT) has become an important issue, as the number of CT examinations has been increasing worldwide. Radiation doses associated with CT are higher in comparison to other imaging procedures. CT-related radiation doses should be monitored and controlled in order to ensure reduction of radiation exposure and optimization of image quality. The aim of this study was to evaluate radiation doses in adult patient who underwent routine CT brain examinations, and to assess how CT scanning protocols affect patient doses in practice.

Material/Methods: A total of 118 patients underwent brain CT at two radiology departments equipped with 64-slice CT scanners, Khartoum, Sudan. Patient doses regarding weighted CT dose index (CTDIw) and dose length product (DLP) values were recorded. Quality control tests were performed for both scanners.

Results: The mean CTDIw values ranged from 62.9 to 65.8 mGy, DLP values ranged from 1003.7 to 1192.5 mGy, and the effective dose varied from 2.4 to 3.7 mSv.

Conclusions: Patient doses in this study was higher compared to previous research, suggesting that patients exposed to unnecessary radiation. Therefore, optimization of radiation doses with the use of specified imaging protocols, well-documented indications for CT, training of technicians, and quality control programs will reduce the necessary radiation doses. Establishment of the diagnostic reference level is recommended for further dose reduction.
Characteristic Multimodal Imaging of Medication- Related Osteonecrosis of the Jaw: Comparison Between Oral and Parenteral Routes of Medication Administration
Authors: Ogura Ichiro , Sasaki Yoshihiko , Kameta Ayako , Sue Mikiko , Oda Takaaki
Published: March 2018

Background: To assess multimodal imaging features of medication-related osteonecrosis of the jaw (MRONJ) and to analyze the differences between oral and parenteral routes of medication administration. We retrospectively reviewed panoramic radiographs, CT, MRI, and bone scintigraphy of patients with MRONJ.

Material/Methods: A retrospective study was conducted in 16 patients with MRONJ who underwent panoramic radiography, CT, MRI, and bone scintigraphy. Statistical analysis for the comparison between routes of medication administration and multimodal imaging features was performed with the Pearson’s χ2 test.

Results: The percentage of cases with sequestrum separation was 25.0% (4/16 cases) on panoramic radiography and 81.3% (13/16 cases) on CT. The percentage of cases with periosteal bone proliferation on CT was 41.7% (5/12 cases) in the oral route of administration vs. 100% (4/4 cases) in the parenteral route of administration (p=0.042). The percentage of cases with spread of soft tissue inflammation to buccal and other spaces on CT and MRI was 33.3% (4/12 cases) in the oral route of administration vs. 100% (4/4 cases) in the parenteral route of administration (p=0.021).

Conclusions: The sequestrum separation on panoramic radiography in patients with MRONJ was unclear in comparison to CT. Furthermore, characteristic CT findings of patients with MRONJ in the parenteral administration group were periosteal bone proliferation and spread of soft tissue inflammation to buccal and other spaces.
Detailed Imaging Findings in a Rare Case of Kimura Disease, with Special Mention on Diffusion Weighted Imaging
Authors: Syed Moinullah , Bhattacharya Divya , Parida Bikash , Sharma Ashok
Published: March 2018

Background: Kimura disease is an uncommon, benign, chronic, idiopathic disease that is seen mainly in the Asian population, particularly in females. It mainly affects the salivary glands and in particular parotid and cervical lymph nodes. So far, the diagnosis of Kimura disease has been based on histopathology. We hereby report of a confirmed case of Kimura disease and provide a detailed explanation of its imaging features with a special emphasis on diffusion-weighted imaging, as diffusion sequences may help distinguish Kimura disease from malignancy.

Case Report: A middle-aged female patient presenting with a history of multiple chronic neck swellings was thoroughly evaluated by ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). The imaging findings included gross enlargement of the left parotid gland, a focal lesion in the right parotid gland, and cervical lymphadenopathy. These features correlated with histopathological findings, and the diagnosis of Kimura disease was made.

Conclusions: The imaging findings were found to be specific for Kimura disease.
Multidetector Computed Tomography (CT) in Evaluation of Congenital Cyanotic Heart Diseases
Authors: Enaba Moanes M. , Hasan Doaa I. , Alsowey Ahmed M. , Elsayed Hany
Published: March 2018

Background: The aim of the study is to emphasize the role of 128 MSCT angiography in the diagnosis of congenital cyanotic heart diseases.

Material/Methods: This study included sixty patients and was conducted from December 2014 to July 2016 in the Multidetector CT unit of Zagazig University hospitals. All images included axial, MPR, MIP, and VRT and were interpreted in one session. Pulmonary veins were assessed for PAPVR or TAPVR, PDA, cardiac apex and heart chambers, interatrial or interventricular septal defects, pericardium, and site and size of the great veins (IVC and SVC).

Results: This study included 60 patients. Thirty-four were boys (56.7%), and 26 were girls (43.3%). The age ranged from nine months to five years, and the mean age was 34.5 months. We found the following anomalies: tetralogy of Fallot (15 patients, 25%), tricuspid atresia (12 patients, 20%), Ebstein’s anomaly (4 patients, 6.5%), pulmonic atresia or stenosis (7 patients, 11.5%), truncus arteriosus (6 patients, 10%), TGA (10 patients, 17%), and TAPVR (6 patients, 10%).

 Conclusions: MDCT proved to be an important modality for decision-making in patients with congenital cyanotic heart diseases.
A Rare Case of Caudal Regression Syndrome in a Foetus of Non-Diabetic Mother: A Case Report
Authors: Chawla Gurnihal Singh , Agrawal Purva Mahesh , Bajwa karanbir Singh
Published: March 2018

Backgound: Caudal regression syndrome (CRS) is an uncommon disorder in which there is abnormal development of the caudal end of the foetal spine along with many associated anomalies. Manifestations of this syndrome can vary from the absence of a few terminal coccygeal segments to complete lumbosacral agenesis. Its overall incidence is 1 in 60000 live births. It is more commonly seen in infants of diabetic mothers, with a 200-fold increased risk as compared to the general population.

Case Report: We present a case of CRS in a foetus of a non-diabetic mother and discuss the role of radiology in early diagnosis and timely management. We also correlate initial abnormalities of the nervous system found on imaging with postnatal clinical deficits.

Conclusions: This case highlights the rarity caudal regression syndrome in a foetus of a non-diabetic mother. Early diagnosis of CRS is important for appropriate management.
Quantitative Computed Tomography (CT) Assessment of Emphysema in Patients with Severe Chronic Obstructive Pulmonary Disease (COPD) and its Correlation with Age, Sex, Pulmonary Function Tests, BMI, Smoking, and Biomass Exposure
Authors: Shaikh Minhaj , Sood Ram Gopal , Sarkar Malay , Thakur Vijay
Published: March 2018

Background: To evaluate the role of HRCT in quantifying emphysema in severe COPD patients and to study the variations in the pattern of emphysema in relation to age, sex, FEV1, smoking index, biomass exposure, and BMI.

Material/Methods: Automatic lung segmentation of HRCT scans in 41 severe COPD patients (GOLD stage III or more) was done using an emphysema protocol. The extent of emphysema was assessed using the density mask method with a threshold of –950 HU (%LAA-950). The percentage of emphysema in each lung lobe and both lungs was correlated with 6 parameters – age, sex, BMI, smoking index, biomass exposure, and FEV1.

Results: Smoking resulted in homogenously distributed emphysema regardless of the severity of smoking. BMI was inversely correlated with the extent of emphysema. A significant association was found between the percentage of emphysema in the right lower lobe and BMI (P=0.015), between biomass exposure and the percentage of emphysema in RUL, RLL, and both lungs (P values of 0.024, 0.016, and 0.036, respectively). The extent of emphysema was disproportionately low compared to the amount of obstruction on PFTs, indicating an airway predominant variety of COPD with significant biomass exposure.

Conclusions: Smoking is associated with a relatively homogenous distribution of emphysema with no regional predilection. Biomass exposure produces predominantly right-sided emphysema. BMI decreases with increasing levels of emphysema in the right lower lobe. These risk factors of emphysema patterns are helpful in deciding on the management, including surgical options.
Tackling Communication Breakdown – Clinically Unjustified Examinations Revisited
Authors: Czarniecki Marcin
Published: March 2018

A lack of communication between the referring clinician and radiologist leads to innumerable unnecessary examinations in the developed world, including Poland. Are the current administrative efforts reaching the right audience and what changes await us in the near future?
Iterative Reconstruction as a Method for Optimisation of Computed Tomography Procedures
Authors: Staniszewska Maria , Chrusciak Dariusz
Published: March 2018

Background: Computed tomography (CT) is still commonly regarded as a method that causes a high radiation exposure. For that reason, producers intensively try to find new solutions for dose reduction while maintaining a high diagnostic value of images. One of the recent strategies focuses on CT image reconstruction. Iterative reconstruction (IR) is an alternative for filtered back projection (FBP) that is commonly used today. The aim of the article is to demonstrate and compare the effects of two IR algorithms on dose value and image details.

Material/Methods: Investigations were performed on two 128 multi-detector (MDCT) CT scanners: – iCT (Philips Healthcare with iDose4); – Definitions AS+ (Siemens Medical Solutions with SAFIRE system). The measurements involved: – image quality indicators for the CATPHAN 600 phantom; – dosimetric indicators of exposure (DLP i CTDIvol).

Results: The signal-to-noise ratios (SNR) in the images reconstructed with IR and FBP were analysed, and the SNR(IR)/SNR(FBP) ratios were calculated and correlated with CTDIvol values. The effects of IR and FBP algorithms on low-contrast resolution were also compared in relation to CTDIvol values. The smallest diameter of supra-slice objects in the Catphan phantom were taken into consideration.

Conclusions: Both iterative algorithms definitely improved the visibility of low-contrast objects in comparison to a standard algorithm (FBP) with similar exposure parameters. These algorithms allow an 80% reduction of the CTDIvol value while maintaining an acceptable visibility of low-contrast objects. However, the results obtained with each of the studied iterative algorithms differ.
Role of Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy and Transrectal Ultrasound in Evaluation of Prostatic Pathologies with Focus on Prostate Cancer
Authors: Lahoti Amol Madanlal , Dhok Avinash Parshuram , Rantnaparkhi Chetana Ramesh , Rawat Jitesh Subhash , Chandak Nihar Umakant , Tawari Hitesh Sharad
Published: March 2018

Background: Prostate cancer (PC) is an important medical and socio-economical problem due to its increasing incidence. The development of the prostate specific antigen (PSA) test, and a continuing decrease in the rates of other common neoplasms, such as lung and stomach since mid-1980s, prostate cancer has become one of the most common cancers among men. Prostate cancer (PC) is the second most common cancer in men, preceded only by lung cancer, and its early diagnosis is crucial for a successful treatment, that will prolong survival and improve quality of life. The main objective of our study was to evaluate the role of magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS) and transrectal ultrasound (TRUS) in detecting prostatic pathologies and staging of prostate cancer by correlating these methods with histopathological results.

Material/Methods: The study is a cross-sectional diagnostic study performed in 66 patients with a high degree of clinical suspicion of prostatic pathology. All patients underwent TRUS, T1W, T2W, DWI, and 3D PRESSMRS sequences, and we also calculated ADC values and Cho Cr/Cit MRS ratios for all patients.

Results: Combination of MRI and MRS showed the highest diagnostic accuracy among the imaging modalities in detecting of prostatic neoplasm, followed by MRI, and then by TRUS. MRS plays a complementary role to MRI, by increasing its diagnostic accuracy. Due to a high cost, limited availability and increased scanning time, combination of MRI and MRS is currently not recommended as a first line investigation for detecting prostate neoplasms, hence USG (TRUS) remains the first line investigation due to its low cost, easy availability, time effectiveness and comparable efficacy.

Conclusions: MRI MRS has more diagnostic accuracy than MRI alone for detection of prostate pathologies. MRS, plays significant complementary role and should be included in the routine MR imaging protocols. MRI helps in diagnosis, localization, better tissue characterization and staging of prostate cancer. TRUS is easily available, cost effective and has comparable efficacy.
Echocardiography in the Evaluation of Chest Pain in the Emergency Department
Authors: Mahmoud Mustafa Z.
Published: March 2018

Background: A challenge for clinicians in emergency departments (EDs) is rapid identification of those patients with chest pain who require admission and urgent management and those with low clinical risk who can be discharged safely from the ED. This study was designed with an aim to evaluate the ability of two-dimensional transthoracic echocardiography (2D-TTE) to determine causes of acute chest pain in patients presenting to the ED in order to decide whether hospital admission and further investigations were needed.

Material/Methods: A total of 250 consecutive patients admitted with chest pain, were enrolled in this prospective study. Patients were divided into three groups: high risk, moderate risk, and low risk of cardiac events, according to cardiovascular risk factors. 2D-TTE was obtained using the HI vision Avius ultrasound unit (Hitachi). Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS), version 20.

Results: Ischemic and/or non-ischemic heart diseases (IHD and/or NIHD) were detected in 147 (86.5%), 13 (7.6%), and 10 (5.9%) patients with high, moderate, and low risk, respectively. 2D-TTE was characterized by sensitivity of 85.86%, specificity of 100%, and positive predictive value (PPV) of 100% for detecting causes of chest pain.

Conclusions: 2D-TTE increased specificity and sensitivity of detecting causes of chest pain, when compared to patient history, clinical findings, and electrocardiography (ECG). 2D-TTE can be used to help determine the need for hospital admission, to confirm or exclude diagnosis, and guide urgent therapy.
Top 50 Highly Cited Articles on Dual Energy Computed Tomography (DECT) in Abdominal Radiology: A Bibliometric Analysis
Authors: Gong Bo , Wu Yuhao , O’Keeffe Michael E. , Berger Ferco H. , McLaughlin Patrick D. , Nicolaou Savvas , Khosa Faisal
Published: March 2018

This study aims to identify the 50 most highly cited articles on dual energy computed tomography (DECT) in abdominal radiology. Thomson Reuters Web of Science All Databases was queried without year or language restriction. Only original research articles with a primary focus on abdominal radiology using DECT were selected. Review articles, meta-analyses, and studies without human subjects were excluded. Fifty articles with the highest average yearly citation were identified. These articles were published between 2007 and 2017 in 12 journals, with the most in Radiology (12 articles). Articles had a median of 7 authors, with all first authors but one primarily affiliated to radiology departments. The United States of America produced the most articles (16), followed by Germany (13 articles), and China (7 articles). Most studies used Dual Source DECT technology (35 articles), followed by Rapid Kilovoltage Switching (14 articles), and Sequential Scanning (1 article). The top three scanned organs were the liver (24%), kidney (16%), and urinary tract (15%). The most commonly studied pathology was urinary calculi (28%), renal lesion/tumor (23%), and hepatic lesion/tumor (20%). Our study identifies intellectual milestones in the applications of DECT in abdominal radiology. The diversity of the articles reflects on the characteristics and quality of the most influential publications related to DECT.
Large–scale digitization of herbarium specimens: Development and usage of an automated, high–throughput conveyor system
Authors: Sweeney Patrick W. , Starly Binil , Morris Paul J. , Xu Yiming , Jones Aimee , Radhakrishnan Sridhar , Grassa Christopher J. , Davis Charles C.
Published: March 2018

The billions of specimens housed in natural science collections provide a tremendous source of under–utilized data that are useful for scientific research, conservation, commerce, and education. Digitization and mobilization of specimen data and images promises to greatly accelerate their utilization. While digitization of natural science collection specimens has been occurring for decades, the vast majority of specimens remain un–digitized. If the digitization task is to be completed in the near future, innovative, high–throughput approaches are needed. To create a dataset for the study of global change in New England, we designed and implemented an industrial–scale, conveyor–based digitization workflow for herbarium specimen sheets. The workflow is a variation of an object–to–image–to–data workflow that prioritizes imaging and the capture of storage container–level data. The workflow utilizes a novel conveyor system developed specifically for the task of imaging flattened herbarium specimens. Using our workflow, we imaged and transcribed specimen–level data for almost 350,000 specimens over a 131–week period; an additional 56 weeks was required for storage container–level data capture. Our project has demonstrated that it is possible to capture both an image of a specimen and a core database record in 35 seconds per herbarium sheet (for intervals between images of 30 minutes or less) plus some additional overhead for container–level data capture. This rate was in line with the pre–project expectations for our approach. Our throughput rates are comparable with some other similar, high–throughput approaches focused on digitizing herbarium sheets and is as much as three times faster than rates achieved with more conventional non–automated approaches used during the project. We report on challenges encountered during development and use of our system and discuss ways in which our workflow could be improved. The conveyor apparatus software, database schema, configuration files, hardware list, and conveyor schematics are available for download on GitHub.
A Gordian knot: Nomenclature and taxonomy of Heterocapsatriquetra (Peridiniales: Heterocapsaceae)
Authors: Prado Jefferson , Lendemer James , Tripp Erin , Gottschling Marc , Tillmann Urban , Kusber Wolf-Henning , Hoppenrath Mona , Elbrächter Malte
Published: March 2018

In the course of polyphasic taxonomic work in the dinophytes, we became aware of a fundamental misapplication of the name Glenodinium triquetrum (now represented conceptually by a species of Kryptoperidinium), when Stein assigned it to Heterocapsa. Possible solutions involve a conflict between retaining Ehrenberg’s epithet in its correct application in the interest of priority and preserving current usage of Heterocapsa. However, we do not achieve a consensus on how to disentangle this Gordian knot, underlining that this is not a regular case of taxonomic confusion. We intend to stimulate a more general discussion about best practices in such cases, balancing between the interest of nomenclatural practicability and the respectful acknowledgement of scientific work, even if it was conducted many years ago.
The way of the development of Slovak literature of the XIX - beginning of XXI century
Authors: Машкова Алла , Mashkova Alla
Published: March 2018

The book presents chapters from the history of Slovak literature XIX — early XXI century, Slovak-Russian literary relations, as well as common Slavic problems. Special sections are devoted to the literary situation in Slovakia after 1918, and "gentle" revolution of 1989, the theme of the First world war, military prose of the second half of the 40-ies of XX century, the image of Russia in the literature of Slovakia, historical prose, "literature of fact", etc. Presented creative portraits P. Th. Safarik, L. Stuhr, SV. Qurban-Vajanskeho, M. Kukushina, J. Jesensky, Th. Tiger-Gronsky, Is Famous For Its Nadasdy, L.-EGE, M. Figuli, J., LENCA, P. Ilikovskogo, P. rankova MD, L. Trubezha, S. RACUS etc. some of the chapters were published in Russian (Moscow state University. M. V. Lomonosov, Institute of Slavic studies of RAS, Institute of world literature of RAS) and foreign publications in 1996– 2017, part is written specifically for this book.
Revision of Antoni Kępiński’s concept of information metabolism
Authors: Ceklarz Jan
Published: March 2018

Metabolizm informacyjny jest kluczowym modelem opisu życia psychicznego w twórczości polskiego psychiatry Antoniego Kępińskiego. W związku ze znaczeniem publicystyki Kępińskiego dla środowiska psychiatrycznego w Polsce, a także jej oddziaływaniem w życiu kulturalnym, poddano krytycznej analizie istotny nurt interpretacyjny tej koncepcji, polegający na utożsamieniu metabolizmu informacyjnego z tzw. modelem biologicznym. Model biologiczny jest postulatem, pojawiającym się w pismach Kępińskiego, aby zagadnienia dotyczące psychiki były opisywane w analogii do struktur somatycznych organizmu, w szczególności biologii komórki. Ten fragment twórczości Kępińskiego stał się głównym powodem jej późniejszej krytyki, która opierała się przede wszystkim na zanegowaniu zasadności stosowania modelu biologicznego w psychologii i psychiatrii. Przy czym wielokrotnie poprzez model biologiczny rozumiano metabolizm informacyjny. W artykule wykazano, że koncepcja metabolizmu informacyjnego nie zawiera w sobie modelu biologicznego. Tym samym ten podstawowy sposób rozumienia struktury psychicznej człowieka w twórczości Kępińskiego nie jest ograniczony wtórną strukturą modelu biologicznego. Na końcu przedstawiono przykład aktualności systemu metabolizmu informacyjnego Kępińskiego w odniesieniu do koncepcji markerów somatycznych Antoniego Damasio.
The “PsychoŻak” program – an example of using positive concepts of mental health in practice
Authors: Sokołowska Ewa , Kluczyńska Sylwia , Zabłocka-Żytka Lidia , Wojda-Kornacka Joanna
Published: March 2018

Od lat postuluje się konieczność rozwijania potencjałów zdrowia jednostki, które umożliwiają utrzymanie zdrowia i efektywne funkcjonowanie w trudnych sytuacjach. Pozytywne modele zdrowia psychicznego m. in. funkcjonalny model zdrowia psychicznego, model kompletnego zdrowia, koncepcja salutogenetyczna i dobrostanu psychologicznego uwzględniają zarówno optymalne, jak i niekorzystne aspekty funkcjonowania człowieka. W artykule zostanie zaprezentowany autorski program promocji zdrowia psychicznego „PsychoŻak”, który został stworzony na podstawie koncepcji pozytywnych zdrowia psychicznego, przeglądu doniesień empirycznych odnośnie wspierania zdrowia oraz badań odnośnie oczekiwań grupy docelowej co do charakteru tego wspierania. Program adresowany jest do młodych dorosłych studiujących na wyższych uczelniach. Jego celem jest wzmacnianie dobrostanu studentów w sferze psychologicznej, emocjonalnej, somatycznej oraz społecznej. Składa się z dziesięciu trzygodzinnych spotkań, podczas których uczestnicy mają możliwość poznania m.in. czym jest zdrowie psychiczne, jak o nie dbać, gdzie szukać pomocy, jak radzić sobie z codziennym stresem. Może on być wykorzystywany przez jednostki szkolnictwa wyższego i tym samym być narzędziem realizującym postulat promocji zdrowia psychicznego na uczelniach wyższych.
Areas of stigma and discrimination of mentally ill people among Internet respondents in Poland
Authors: Babicki Mateusz , Kotowicz Kamila , Piotrowski Patryk , Stramecki Filip , Kobyłko Agnieszka , Rymaszewska Joanna
Published: March 2018

Cel pracy

Dane epidemiologiczne wskazują, że zaburzenia psychiczne coraz częściej występują w polskiej populacji. Świadomość dotycząca ich pochodzenia, rozpowszechnienia, objawów a także sposobów leczenia jest wciąż ograniczona. Związane z zaburzeniami psychicznymi zjawisko stygmatyzacji jest ważne ze względów moralnych a także praktycznych. Stygmatyzacja oraz dyskryminacja bardzo silnie wpływają na decyzję o podjęciu procesu terapeutycznego, a także jego przebiegu u osób chorych, w rezultacie więc na możliwość ich powrotu do normalnego funkcjonowania w życiu codziennym i pełnieniu ról społecznych.
Celem pracy było zbadanie opinii dotyczącej postrzegania osób chorych psychicznie, ich stygmatyzacji oraz dystansu wobec nich w Polsce.

Metoda

Grupa złożona z 1309 respondentów została przebadana autorskim kwestionariuszem rozpowszechnionym za pomocą mediów internetowych.

Wyniki

Wyniki badania wskazują na wysoki poziom stygmatyzacji pacjentów psychiatrycznych zarówno w subiektywnej ocenie ich wyglądu, intelektu, jak i poczucia wyższości nad nimi. Piętno pacjenta psychiatrycznego bardzo mocno ukazane jest również w aspekcie ekonomicznym wynikającym z niechęci respondentów do zatrudnienia, a nawet współpracy z osobami dotkniętymi schorzeniami z kręgu chorób psychicznych.

Wnioski

Niewątpliwie jednym z priorytetów w dziedzinie zdrowia psychicznego staje się przeciwdziałanie zjawisku stygmatyzacji oraz dyskryminacji osób dotkniętych problemem zdrowia psychicznego.