An unusual case of Multiple Inflammatory Myofibroblastic Tumors of the lung

Inflammatory myofibroblastic tumor (IMT) of the lung is a rare, usually solitary lesion that is considered nowadays as a true neoplasm with unpredictable clinical course. Herein we describe a case of multiple, bilateral IMTs of the lung in a 70 year-old asymptomatic woman, where diagnosis was established by CT guided core biopsy. To our knowledge only 10 cases of bilateral IMTs have been reported in a few case series and in only 2 cases of pulmonary IMTs, CT guided biopsy could establish the correct diagnosis

Magnetic Resonance Imaging of the Hips of Runners Before and After their First Marathon Run: Does it Lead to Acute Changes?

BACKGROUND: No studies have focused on magnetic resonance imaging (MRI) of the hips of marathoners, despite the popularity and injury risks of marathon running. PURPOSE: To understand the effect of preparing for and completing a marathon run (42 km) on runners’ hip joints by comparing MRI findings before and after their first marathon. Study Design: Case-control study; Level of evidence, 3. METHODS: A total of 28 healthy adults (14 males, 14 females; mean age, 32.4 years) were recruited after registering for their first marathon. They underwent 3-T MRI of both hips at 16 weeks before (time point 1) and 2 weeks after the marathon (time point 2). After the first MRI, 21 runners completed the standardized, 4 month--long training program and the marathon; 7 runners did not complete the training or the marathon. Specialist musculoskeletal radiologists reported and graded the hip joint structures using validated scoring systems. Participants completed the Hip disability and Osteoarthritis Outcome Score (HOOS) at both imaging time points. RESULTS: At time point 1, MRI abnormalities of the hip joint were seen in 90% of participants and were located in at least 1 of these areas: labrum (29%), articular cartilage (7%), subchondral bone marrow (14%), tendons (17%), ligaments (14%), and muscles (31% had moderate muscle atrophy). At time point 2, only 2 of the 42 hips showed new findings: a small area of mild bone marrow edema appearance (nonweightbearing area of the hip and not attributable to running). There was no significant difference in HOOS between the 2 time points. Only 1 participant did not finish the training because of hip symptoms and thus did not run the marathon; however, symptoms resolved before the MRI at time point 2. Six other participants discontinued their training because of non–hip related issues: a knee injury, skin disease, a family bereavement, Achilles tendon injury, illness unrelated to training, and a foot injury unrelated to training. CONCLUSION: Runners who completed a 4-month beginner training program before their first marathon run, plus the race itself, showed no hip damage on 3-T MRI scans

Quantitative 3D analysis of bone in hip osteoarthritis using clinical computed tomography.

OBJECTIVE: To assess the relationship between proximal femoral cortical bone thickness and radiological hip osteoarthritis using quantitative 3D analysis of clinical computed tomography (CT) data. METHODS: Image analysis was performed on clinical CT imaging data from 203 female volunteers with a technique called cortical bone mapping (CBM). Colour thickness maps were created for each proximal femur. Statistical parametric mapping was performed to identify statistically significant differences in cortical bone thickness that corresponded with the severity of radiological hip osteoarthritis. Kellgren and Lawrence (K&L) grade, minimum joint space width (JSW) and a novel CT-based osteophyte score were also blindly assessed from the CT data. RESULTS: For each increase in K&L grade, cortical thickness increased by up to 25 % in distinct areas of the superolateral femoral head-neck junction and superior subchondral bone plate. For increasing severity of CT osteophytes, the increase in cortical thickness was more circumferential, involving a wider portion of the head-neck junction, with up to a 7 % increase in cortical thickness per increment in score. Results were not significant for minimum JSW. CONCLUSIONS: These findings indicate that quantitative 3D analysis of the proximal femur can identify changes in cortical bone thickness relevant to structural hip osteoarthritis. KEY POINTS: • CT is being increasingly used to assess bony involvement in osteoarthritis • CBM provides accurate and reliable quantitative analysis of cortical bone thickness • Cortical bone is thicker at the superior femoral head-neck with worse osteoarthritis • Regions of increased thickness co-locate with impingement and osteophyte formation • Quantitative 3D bone analysis could enable clinical disease prediction and therapy development.TT acknowledges the support of an Evelyn Trust Clinical Training Fellowship award (RG65411). KP acknowledges support of an Arthritis Research UK Research Progression award (RG66087), and the Cambridge NIHR Biomedical Research Centre (RG64245). None of the funding sources had a role in study design, data handling, writing of the report, or decision to submit the paper for publication.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s00330-015-4048-

Astma hos ett barn i familjen : - Ett föräldraperspektiv

Bakgrund: Föräldrars kunskap och delaktighet i omvårdnaden av ett barn med astma är nödvändig för barnets välbefinnande. Utifrån ett systemteoretiskt perspektiv är det därför betydelsefullt att belysa hur föräldrar påverkas av barnets ohälsa för att som sjuksköterska kunna ge stöd till hela familjen. Syfte: Att belysa hur astma hos ett barn i familjen påverkar föräldrarna. Metod: Föreliggande studie är en systematisk litteraturstudie. I databaserna Cinahl, PsycINFO och PubMed påträffades 11 kvalitativa samt kvantitativa artiklar vilka svarade mot syftet. Calgary Family Assessment Model utgjorde ett teoretiskt raster vid analysen och ligger till grund för resultatets övergripande tematisering. Resultat: Föräldrar påverkades praktiskt, känslomässigt och beteendemässigt. Astman medförde noggrann planering, omfattande restriktioner samt upptog mycket tid. Svårare astmaepisoder var påfrestande för föräldrarna med känslor av panik, rädsla och hjälplöshet. Oro kring medicinering och framtid samt social isolering var också framträdande. Mödrar intog ofta den beskyddande rollen och verkade som huvudvårdgivare. De starka banden mellan mor och barn påverkade relationerna med övriga familjemedlemmar vilka ofta kände sig bortglömda. Olika strategier och resurser framkom som viktiga såsom att söka information, erhålla socialt stöd samt att ha en positiv inställning. Diskussion/Slutsats: Genom en systemteoretisk förståelse kan sjuksköterskan få en insikt i hur föräldrar påverkas av barnets ohälsa. På så sätt skapas bättre förutsättningar för god omvårdnad av hela familjen

Ultrasonography of symptomatic rotator cuff tears compared with MR imaging and surgery

Purpose: To compare the accuracy of ultrasonography and magnetic resonance imaging in the detection of rotator cuff tears. Materials and methods: Ninety-six patients with clinically suspected rotator cuff pathology underwent ultrasonography and magnetic resonance imaging of the shoulder. The findings in 88 patients were compared with arthroscopy or open surgery. Results: Full-thickness tear was confirmed in 57 cases, partial-thickness tear in 30 cases and degenerative changes without tear in 1. In all 57 cases of full-thickness tear and in 28 out of 30 cases of partial-thickness tear the supraspinatus tendon was involved. The accuracy in the detection of full-thickness tears was 98% and 100% for ultrasonography and magnetic resonance imaging, respectively. The accuracy in the detection of bursal or articular partial-thickness tears was 87% and 90% for ultrasonography and magnetic resonance imaging, respectively. Conclusions: In experienced hands ultrasonography should be considered as an accurate modality for the initial investigation of rotator cuff, especially supraspinatus, tears.Οι ρήξεις του μυοτενόντιου πετάλου της άρθρωσης του ώμου αποτελούν συνηθισμένη αιτία ωμαλγίας. Η έγκαιρη διάγνωσή τους συμβάλει στην ορθή αντιμετώπισή τους και τον περιορισμό της λειτουργικής δυσλειτουργίας της άρθρωσης. Η υπερηχογραφική εξέταση του μυοτενόντιου πετάλου του ώμου πραγματοποιήθηκε για πρώτη φορά περίπου πριν από δύο δεκαετίες, με τις πρώτες δημοσιεύσεις από τον Seltzer και συνεργάτες το 1979. Κατά τα πρώτα στάδια εφαρμογής της, δεν έτυχε ιδιαίτερης απήχησης. Επιπλέον, η μαγνητική τομογραφία έγινε σύντομα η μέθοδος εκλογής για την απεικονιστική αξιολόγηση της άρθρωσης του ώμου. Η σχετικά πρόσφατη τεχνολογική εξέλιξη των υψηλής ευκρίνειας υπερήχων βελτίωσε ουσιαστικά την ποιότητα των εικόνων, εκτινάσσοντας το ενδιαφέρον για την υπερηχογραφική διάγνωση των ρήξεων του μυοτενόντιου πετάλου του ώμου. Στη βιβλιογραφία η υπερηχογραφία αναφέρεται ως αξιόπιστη μέθοδος για τον εντοπισμό ολικού πάχους ρήξεων του στροφικού πετάλου, αλλά η ακρίβειά της στην ανίχνευση των μερικού πάχους ρήξεων είναι υπό αμφισβήτηση. Σκοπό της παρούσας προοπτικής μελέτης αποτέλεσε η σύγκριση της διαγνωστικής αξίας της υπερηχογραφίας και της μαγνητικής τομογραφίας για την ανίχνευση των ολικού και μερικού πάχους ρήξεων του μυοτενόντιου πετάλου του ώμου σε συμπτωματικούς ασθενείς, στα πλαίσια σύγχρονου εξοπλισμού και τυποποιημένων τεχνικών και κριτηρίων

Evaluating the accuracy of preoperative imaging for diagnosing rotator cuff tears in a regional centre

To review the diagnostic performance of ultrasonography (US) and magnetic resonance imaging (MRI) for the detection of rotator-cuff tears, we performed a retrospective audit of patients who underwent shoulder arthroscopy at Hinchingbrooke hospital. The diagnostic accuracies of US for full and partial-thickness tears were 82% and 28% respectively. Those of MRI were 82% and 81% respectively. These were lower than expected from the literature. This discrepancy is likely to be the consequence of over-diagnosis in imaging and under-diagnosis at arthroscopy

Classification of Compressed Remote Sensing Multispectral Images via Convolutional Neural Networks

Multispectral sensors constitute a core Earth observation image technology generating massive high-dimensional observations. To address the communication and storage constraints of remote sensing platforms, lossy data compression becomes necessary, but it unavoidably introduces unwanted artifacts. In this work, we consider the encoding of multispectral observations into high-order tensor structures which can naturally capture multi-dimensional dependencies and correlations, and we propose a resource-efficient compression scheme based on quantized low-rank tensor completion. The proposed method is also applicable to the case of missing observations due to environmental conditions, such as cloud cover. To quantify the performance of compression, we consider both typical image quality metrics as well as the impact on state-of-the-art deep learning-based land-cover classification schemes. Experimental analysis on observations from the ESA Sentinel-2 satellite reveals that even minimal compression can have negative effects on classification performance which can be efficiently addressed by our proposed recovery scheme

3.0 T MRI findings of 104 hips of asymptomatic adults: from non-runners to ultra-distance runners

Objectives To determine and compare the health status of hip joints of individuals undertaking various lengths of long-distance running and of those who are not running.Methods Fifty-two asymptomatic volunteers underwent bilateral hip 3.0 Tesla MRI: (1) 8 inactive non-runners; (2) 28 moderately active runners (average half a marathon (21 km)/week) and (3) 16 highly active runners (≥ marathon (42 km)/week). Two musculoskeletal radiologists reported the hip MRI findings using validated scoring systems. Study participants completed a Hip disability and Osteoarthritis Outcome Score (HOOS) questionnaire to indicate their perceived hip function.Results The MRI findings show that there were no significant differences among inactive non-runners, moderately active runners and highly active runners in the amount of labral abnormalities (p=0.327), articular cartilage lesions (p=0.270), tendon abnormalities (p=0.141), ligament abnormalities (p=0.519). Bone marrow oedema was significantly more common in moderately active runners than in non-runners and highly active runners (p=0.025), while small subchondral cysts were more common in runners than in non-runners (p=0.017), but these were minor/of small size, asymptomatic and did not indicate specific exercise-related strain. Articular cartilage lesions and bone marrow oedema were not found in highly active runners. HOOS scores indicate no hip symptoms or functional problems among the three groups.Conclusion The imaging findings were not significantly different among inactive non-runners, moderately active runners and highly active runners, in most hip structures, suggesting that long-distance running may not add further damage to the hip joints