Evaluation of magnetic resonance imaging guidelines for differentiation between thoracolumbar intervertebral disk extrusions and intervertebral disk protrusions in dogs

Four MRI variables have recently been suggested to be independently associated with a diagnosis of thoracolumbar intervertebral disk extrusion or protrusion. Midline intervertebral disk herniation, and partial intervertebral disk degeneration were associated with intervertebral disk protrusion, while presence of a single intervertebral disk herniation and disk material dispersed beyond the boundaries of the intervertebral disk space were associated with intervertebral disk extrusion. The aim of this retrospective, cross‐sectional study was to determine whether using these MRI variables improves differentiation between thoracolumbar intervertebral disk extrusions and protrusions. Eighty large breed dogs with surgically confirmed thoracolumbar intervertebral disk extrusions or protrusions were included. Randomized MRI studies were presented on two occasions to six blinded observers, which were divided into three experience categories. During the first assessment, observers made a presumptive diagnosis of thoracolumbar intervertebral disk extrusion or protrusion without guidelines. During the second assessment they were asked to make a presumptive diagnosis with the aid of guidelines. Agreement was evaluated by Kappa‐statistics. Diagnostic accuracy significantly improved from 70.8 to 79.6% and interobserver agreement for making a diagnosis of intervertebral disk extrusion or intervertebral disk protrusion improved from fair (κ = 0.27) to moderate (κ = 0.41) after using the proposed guidelines. Diagnostic accuracy was significantly influenced by degree of observer experience. Intraobserver agreement for the assessed variables ranged from fair to excellent and interobserver agreement ranged from fair to moderate. The results of this study suggest that the proposed imaging guidelines can aid in differentiating thoracolumbar intervertebral disk extrusions from protrusions

Usefulness of Pain Distribution Pattern Assessment in Decision-Making for the Patients with Lumbar Zygapophyseal and Sacroiliac Joint Arthropathy

There are currently no initial guides for the diagnosis of somatic referred pain of lumbar zygapophyseal joint (LZJ) or sacroiliac joint (SIJ). We developed a classification system of LZJ and SIJ pain, the "pain distribution pattern template (PDPT)" depending on the pain distribution patterns from a pool of 200 patients whose spinal pain source was confirmed. We prospectively applied the PDPT to determine its contribution to clinical decision-making for 419 patients whose pain was presumed to arise from the LZJs (259 patients) or SIJs (160 patients). Forty-nine percent (128/259) of LZJ and 46% (74/160) of SIJ arthopathies diagnosed by PDPT were confirmed by nerve blocks. Diagnostic reliabilities were significantly higher in Type A and C patterns in LZJ and Type C in SIJ arthropathies, 64%, 80%, and 68.4%, respectively. For both LZJ and SIJ arthropathies, favorable outcome after radiofrequency (RF) neurotomies was similar to the rate of positive responses to diagnostic blocks in Type A to Type D, whereas the outcome was unpredictable in those with undetermined type (Type E). Considering the paucity of currently available diagnostic methods for LZJ and SIJ arthropathies, PDPT is useful in clinical decision-making as well as in predicting the treatment outcome

A comparative study of cranial, blunt trauma fractures as seen at medicolegal autopsy and by Computed Tomography

<p>Abstract</p> <p>Background</p> <p>Computed Tomography (CT) has become a widely used supplement to medico legal autopsies at several forensic institutes. Amongst other things, it has proven to be very valuable in visualising fractures of the cranium. Also CT scan data are being used to create head models for biomechanical trauma analysis by Finite Element Analysis. If CT scan data are to be used for creating individual head models for retrograde trauma analysis in the future we need to ascertain how well cranial fractures are captured by CT scan. The purpose of this study was to compare the diagnostic agreement between CT and autopsy regarding cranial fractures and especially the precision with which cranial fractures are recorded.</p> <p>Methods</p> <p>The autopsy fracture diagnosis was compared to the diagnosis of two CT readings (reconstructed with Multiplanar and Maximum Intensity Projection reconstructions) by registering the fractures on schematic drawings. The extent of the fractures was quantified by merging 3-dimensional datasets from both the autopsy as input by 3D digitizer tracing and CT scan.</p> <p>Results</p> <p>The results showed a good diagnostic agreement regarding fractures localised in the posterior fossa, while the fracture diagnosis in the medial and anterior fossa was difficult at the first CT scan reading. The fracture diagnosis improved during the second CT scan reading. Thus using two different CT reconstructions improved diagnosis in the medial fossa and at the impact points in the cranial vault. However, fracture diagnosis in the anterior and medial fossa and of hairline fractures in general still remained difficult.</p> <p>Conclusion</p> <p>The study showed that the forensically important fracture systems to a large extent were diagnosed on CT images using Multiplanar and Maximum Intensity Projection reconstructions. Difficulties remained in the minute diagnosis of hairline fractures. These inconsistencies need to be resolved in order to use CT scan data of victims for individual head modelling and trauma analysis.</p

Somewhat united: primary stakeholder perspectives of the governance of schoolboy football in Ireland

Despite an independent report on the governance and organisational practices of football in Ireland, the National Governing Body continues to face criticism in relation to stakeholder management and communication. As positive outcomes in non-profit organisations are associated with quality relationships between organisations, the purpose of this article is to explore primary stakeholder perspectives of the governance of schoolboy football in the Republic of Ireland. The research questions to be addressed are: do tensions exist between stakeholders and does the FAI display effective governance behaviours in relation to its primary stakeholders. Semi-structured interviews were conducted with seven stakeholders from the football governance system. A lack of congruence across the system was identified, which resulted from ineffective stakeholder management (poor communication practices, perceptions of inaccurate disclosures, perceived lack of inclusion in decision-making, perceptions of organisational injustice, confusion over role clarity and responsibilities). Managing the quality of the relationships with diverse stakeholders within a sport governance system is key for strategic policy formation and implementation, yet this remains a challenging and multi-faceted concept. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group

Is There any Relationship between Narcissistic Personality and Organizational Commitment?

ABSTRACT OBJECTIVE: This study aimed at investigating whether there is a correlation between organizational commitment and narcissistic personalty traits. METHOD: In order to measure the GATA Occupation High School of Health Subordinate Officiers&#8217; narcissistic personality traits Narcissistic Personality Inventory (NPI) scala was used. In order to measure students&#8217; organizational commitment Organizational Commitment Questionnaire was used. 229 questionnaire forms were distributed to the Occupation High School of Health Subordinate Officiers&#8217; students, and 220 (%96) of them were returned. Totally 220 students were evaluated. FINDINGS: When students&#8217; narcissistic scores were evaluated out of 16, it was found out that the highest narcissistic personality score (8,98) was taken by second year students, the highest score for organizational commitment (3,70) was taken by first year students, &#8220;exploitativeness&#8221; which is one of the sub-levels of narcissisim was observed at the highest level with an average of 0,73 out 1 full score, &#8220;entitlement&#8221; sub level was observed at the lowest level (0,29), &#8220;affective commitment&#8221; one of the sub-levels of commitment, had the highest average (3,84), &#8220;normative commitment&#8221; had the second highest average (3,71) and finally &#8220;continuance commitment&#8221; was observed at the lowest level (3,55). Statistically, there is no significant relationship found between narcissistic personality and organizational commitment. However, there is a significant relationship found between narcissistic personality and continuity commitment. There is a significant and opposite relationship found between organizational commitment and continuity commitment with superiority. There is similar relationship found between exploitation and continuity commitment. CONCLUSION: With respect to these findings, it is suggested that &#8220;Health Technicians&#8221; candidates&#8217;, who will be one of the indispensable constituents of health services in the future, narcissistic personality traits should be known to improve their organizational commitment and necessary precautions should be taken as a part of their education in order to develop their narcissistic personality. [TAF Prev Med Bull 2012; 11(2.000): 119-126

Collateral pathways in superior vena caval obstruction as seen on CT

Purpose: Collateral venous pathways occurring with superior vena cava (SVC) obstruction were examined based on CT scans obtained from the thoracic inlet to the pubic symphysis. Similarities and variations from the prior classification scheme were analyzed. Method: A retrospective review of our database resulted in a cohort comprising 21 CT scans from 19 patients. The location and frequency of each collateral pathway and the level of the SVC obstruction were tabulated. An accepted classification scheme was applied to the collateral patterns in each case. Additional and atypical features were noted. Results: Fifteen common collateral veins were found that could be grouped into one to four collateral pathways. Unusual shunts, including hepatic parenchymal and pulmonary pathways, were found. Thirteen cases (62%) varied from the standard classification owing to different occlusion levels or presence of other collaterals. No statistically significant relationship between the level of occlusion and the number of collateral pathway groups was found. The most common abdominal collateral veins were those along the liver surface (52.3% of cases), although 18 patients (94.7%) had at least one collateral vein visible in the abdomen. Conclusion: The spectrum of venous collateral formations as seen on thoracoabdominal CT scans often includes collaterals at or below the level of the diaphragm, including intrahepatic shunts. Many collateral patterns found in this series could not be classified with the existent classification scheme.link_to_subscribed_fulltex

Isolated giant intrathoracic meningocele associated with vertebral corpus deformity

Published reports of intrathoracic meningocele with vertebral corpus defects in the absence of neurofibromatosis are very rare. We report a 9-year-old male with intrathoracic meningocele. We believe that vertebral corpus defects may play a certain role in the etiology of intrathoracic meningocele. © 2004 Elsevier B.V. All rights reserved