The comparison of CT fistulography and MR imaging of perianal fistulae with surgical findings: a case–control study

PubMedID: 27034072Purpose: The purpose of this study was to evaluate the diagnostic efficacies of CT fistulography and MRI, in the diagnostic work-up of perianal fistula patients. Materials and methods: All 41 patients who were included in the study (36 males and 5 females, with an average age of 41 years) underwent CT fistulography and MRI examinations prior to surgery. The fistula characteristics obtained from these examinations were compared with the surgical findings. The comparative results were evaluated by means of the Kappa analysis method. Results: CT fistulography predicted the correct perianal fistula classification in 30 (73.1%) of the 41 patients, whereas MRI correctly defined fistula classification in 38 (92.7%) of these patients (the K values were 0.621 and 0.896, respectively; with p < 0.001). CT fistulography depicted 29 secondary extensions in 16 patients, whereas MR imaging revealed 28 secondary extensions in 15 patients. A substantial agreement was found between surgical findings and two modalities (K value was 0.789 and 0.793 for CT fistulography and MRI, respectively, with a p value < 0.001). In terms of locations of internal openings, CT fistulography was able to detect the locations in 28 patients (68.2%), whereas MRI was more successful in this aspect, with a number of 35 patients (85.3%). Granulation tissues, inflammation and edema around the fistula, abscesses, and fistular wall fibrosis were also evaluated. Conclusion: CT fistulography and MRI have different advantages in the diagnosis of perianal fistulas. A good command of knowledge concerning the issue may be a key factor in modality decision. © 2016, Springer Science+Business Media New York

An unexpected cause of small bowel obstruction in an adult patient: midgut volvulus

The most important complication of intestinal malrotation is midgut volvulus because it may lead to intestinal ischaemia and necrosis. A 29-year-old male patient was admitted to the emergency department with abdominal pain. Ultrasonography (US), colour Doppler ultrasonography (CDUS), CT and barium studies were carried out. On US and CDUS, twisting of intestinal segments around the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) and alteration of the SMA–SMV relationship were detected. CT demonstrated that the small intestine was making a rotation around the SMA and SMV, which amounted to more than 360°. The upper gastrointestinal barium series revealed a corkscrew appearance of the duodenum and proximal jejunum, which is a pathognomonic finding of midgut volvulus. Prior knowledge of characteristic imaging findings of midgut volvulus is essential in order to reach proper diagnosis and establish proper treatment before the development of intestinal ischaemia and necrosis

You use! I use! We use! Questioning the orthodoxy of 1:1 computing in primary schools

The current orthodoxy regarding computer use in schools appears to be that 1:1 computing, i.e. each child owns or has sole access to a computing device, is the most efficacious way to achieve a range of desirable educational outcomes including individualised learning, collaborative environments or constructivist pedagogies. This article challenges this notion suggesting instead that 1:2 computing is an appropriate means of achieving such aims in Primary School. It further suggests that 1:2 computing is preferable to 1:1 computing to achieve a balance between productivity, student engagement, social activity and individualised learning. This article draws on data collected during the 2009 school year from four, Year 7 Classrooms (11-13 year old students) who had varied patterns of access to netbook computers. Detailed information was collected from two pieces of software installed in each computer. Data were analysed through an Activity Theory conceptual and methodological lens. Recommendations from this research will assist school leaders make informed decisions regarding 1:1 and 1:2 computing

USING AFFORDABLE TECHNOLOGY TO DECREASE DIGITAL INEQUALITY

School systems in the United States are increasingly integrating computers into the classroom. Yet, we know little about the factors that determine successful adoption, use, and attitudes toward the computers. The City Council of Birmingham, Alabama is the first in the United States to provide One Laptop Per Child XO laptops to all students in first-fifth grades in the Birmingham City School System. The purpose of this study is to present the survey results examining factors that are related to XO laptop usage and attitudes among fourth-and fifth-grade students in Birmingham City schools. The results indicate that factors vary depending upon the type of use or attitudes being examined. Teachers\u27 use of the XO laptop in the classroom is a primary factor that is related to the frequency of XO activity use and students\u27 attitudes toward the XOs, while teachers\u27 ability is related to the hours of XO usage in school. These results highlight the importance of having well-trained teachers who embrace using the XO laptop in the classroom in order to facilitate positive attitudes toward technology and its use among students. © 2011 Taylor & Francis