Bony avulsion of the supraspinatus origin from the scapular spine

We describe a case of an avulsion of the scapular spine at the origin of the supraspinatus muscle, with successful conservative treatment. An isolated avulsion is rare, as most avulsions occur in combination with other (more severe) injuries such as fractures of the scapula body or neck, coracoid process, glenoid or humerus. These injuries are mostly seen in high-energy trauma cases and need their own specific treatment. One should therefore always rule out concurrent trauma before treating conservatively

Metastatic breast carcinoma of the coracoid process: two case reports

<p>Abstract</p> <p>Background</p> <p>The coracoid process of the scapula is a rare site of involvement for metastatic disease or for primary tumors. We are unaware of any reports in the literature of pathologic coracoid process fractures and only one report of metastatic disease to the coracoid.</p> <p>Methods and Results</p> <p>In this case report, we present two cases with metastatic breast carcinoma of the coracoid process, one of which presented with a pathologic fracture of the coracoid.</p> <p>Conclusions</p> <p>An orthopaedic surgeon must be aware of the potential for metastatic disease to the coracoid as they may be the first medical provider to encounter evidence of malignant disease.</p

Bowing fracture of the inferior angle of the scapula, a difficult diagnosis

A 4-year-old boy presented with swelling over the inferior tip of the scapula and an unclear history. Initial radiographic findings were concerning for an aggressive lesion. This case highlights how a multimodality imaging approach was used to relieve uncertainty by diagnosing a paediatric bowing type fracture of the scapular tip

High-accuracy determination of the neutron flux in the new experimental area n_TOF-EAR2 at CERN

A new high flux experimental area has recently become operational at the n_TOF facility at CERN. This new measuring station, n_TOF-EAR2, is placed at the end of a vertical beam line at a distance of approximately 20m from the spallation target. The characterization of the neutron beam, in terms of flux, spatial profile and resolution function, is of crucial importance for the feasibility study and data analysis of all measurements to be performed in the new area. In this paper, the measurement of the neutron flux, performed with different solid-state and gaseous detection systems, and using three neutron-converting reactions considered standard in different energy regions is reported. The results of the various measurements have been combined, yielding an evaluated neutron energy distribution in a wide energy range, from 2meV to 100MeV, with an accuracy ranging from 2%, at low energy, to 6% in the high-energy region. In addition, an absolute normalization of the n_TOF-EAR2 neutron flux has been obtained by means of an activation measurement performed with 197Au foils in the beam.Peer reviewe

On dyspnoea in advanced cancer

The literature on dyspnoea in advanced cancer is reviewed. In a study of 968 patients, dyspnoea was shown to be common and commonly severe. Survival was inversely proportional to severity and prevalence. Established methods of measuring dyspnoea - visual analogue scales (VAS) and word and numeric scales were tested. A new measure of dyspnoea, the Dyspnoea Assessment Questionnaire (DAQ) was developed incorporating qualitative as well as quantitative aspects of dyspnoea. It correlated well with the VAS. Dyspnoea was less well controlled than pain. Another new measure, the Dyspnoea Exertion Score (DES) did not correlate with VAS scores. Measurement of psychological status by the Crown-Crisp Experiential Index (CCEI) showed raised scores for anxiety, obsessionality and depression for terminal cancer patients. In dyspnoeic patients, only anxiety levels were higher than in the non-dyspnoeic. Lung and pleural tumours, smoking and the hyperventilation syndrome (HVS) were risk factors for dyspnoea. The Hyperventilation Provocation Test (HVPT) was used to diagnose HVS. CCEI anxiety scores were higher in HVS than in either non-HVS or dyspnoeic patients. HVS was diagnosed in 1 in 5 patients tested. In conclusion: dyspnoea is a major problem in advanced cancer; a new method of measuring it was developed; HVS is a common cause.</p