Financial Crisis - U.K. Policy and Regulatory Response

WOS: 000405283200015PubMed ID: 2875201

Mammographic features of the sternalis muscle

WOS: 000285038500005PubMed ID: 20700868PURPOSE To evaluate the mammographic findings of the sternalis muscle and discuss appropriate diagnostic approaches. MATERIALS AND METHODS Ten years of records from our mammography unit were retrospectively examined for the presence of the sternalis muscle. This variant was seen in 10 women out of the 52,930 examined, and the mammograms of these patients were reevaluated. The size, shape and contours of the muscle were reviewed on the craniocaudal (CC) and mediolateral oblique (MLO) views. Yearly mammograms were assessed to evaluate follow-up changes. Extra examinations were reviewed, including ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). RESULTS The prevalence of the sternalis muscle was 0.018%. Its contours were well-defined, irregular or spiculated, and the diameter ranged from 3-4 mm to 15 mm. The shape of the muscle varied from slightly bulging to round or triangular. The muscle was detected on MLO projections in three patients as an inferior soft tissue density at the posterior edge of the breast, continuous with the pectoralis muscle. Distinct pulling of the breast led to variations in the appearance of the muscle on yearly mammograms. US examinations were normal in all patients. CT and MRI showed the muscle clearly. CONCLUSION The appearance of the sternalis muscle may vary on CC views. It may also be detected on MLO projections. The ability to visualize the muscle depends on proper positioning. Knowledge of its detectability on mammograms will prevent the misdiagnosis of a mass and prevent further unnecessary investigations

Kardiyak Arrest Hastalarında Brain Arrest Neurological Outcome Scale (BrANOS) ile Mortalite ve Morbidite Tahmini

Objective: There are several prediction scales and parameters for prognosis after a cardiac arrest. One of these scales is the brain arrest neurological outcome scale (BrANOS), which consists of duration of cardiac arrest, Glasgow Coma Scale score and Hounsfield unit measured on cranial computed tomography (CT) scan. The objective of this study is to investigate the effectiveness of BrANOS on predicting the mortality and disability after a cardiac arrest.Methods: We retrospectively investigated cardiac arrest patients who were hospitalized in our intensive care unit (ICU) within a 3-year period. Inclusion criteria were age over 18 years old, survival of more than 24 hours after cardiac arrest and availability of cranial CT. We recorded the age, sex, diagnosis, duration of cardiac arrest and hospital stay, mortality, Glasgow Outcome Score (GOS) and BrANOS score. The primary endpoint of the study was to establish the relationship between mortality and BrANOS score in patients who survived for more than 24 hours after a cardiac arrest. The secondary endpoint of the study was to determine the 2-year life expectancy and GOS after cardiac arrest.Results: The mean age of the patients was 57±17 years (33 females, 67 males). ICU mortality rate was 57%. The BrANOS mean score was 10.3±3.2. There was a significant difference between survivors and non-survivors in terms of the BrANOS score (8.8±3.2 vs. 11.6±2.7; p0.001). BrANOS reliably predicted the survival with a ROC area under the curve of 0.733. The scale of >14 predicted death with 100% accuracy. All the patients without disability had a BrANOS score of 10. The BrANOS score also correlated well with GOS (p0.001). The 2-year life expectancy rate was 31% in patients who survived more than 24 hours after a cardiac arrest.Conclusion: In this study, we demonstrated that BrANOS provided reliable data for prognostic evaluation after a cardiac arrestAmaç: Kardiyak arrest sonrası prognoz tahmini için çeşitli skorlama sistemleri ve parametreler mevcuttur. Bu skorlama sistemlerinden bir tanesi olan BrANOS (Brain Arrest Neurological Outcome Scale); kardiyak arrest süresi, Glasgow koma skala puanı ve kranial bilgisayarlı tomografide (BT) ölçülen Hounsfield Ünitesi'nden oluşur. Bu çalışmanın amacı kardiyak arrest sonrası mortalite ve morbidite üzerine BrANOS'un etkinliğini araştırmaktır. Yöntemler: Üç yıl boyunca Yoğun Bakım Ünitesi'ne yatan kardiyak arrest hastaları retrospektif olarak incelendi. Çalışmaya alınma kriterleri hastanın 18 yaşından büyük olması, kranial BT çekilmesi ve arrest sonrası 24 saatten fazla hayatta kalması idi. Yaş, cinsiyet, tanı, kardiyak arrest süresi, hastanede kalış, mortalite, Glasgow sonuç skoru (GSS) ve BrANOS puanı kaydedildi. Çalışmanın birincil sonlanım noktası kardiyak arrest sonrası 24 saatten fazla hayatta kalan hastalarda BrANOS puanı ile mortalite arasındaki ilişkiyi saptamaktır. İkincil sonlanım noktaları ise arrest sonrası iki yıllık yaşam beklentisini ve GSS'u belirlemektir. Bulgular: Hastaların ortalama yaşı 57±17 yıl (33 kadın, 67 erkek) idi. Yoğun Bakım Ünitesi mortalitesi %57 iken; ortalama BrANOS puanı 10,3±3,2 idi. Hayatta kalan ve ölenler arasında BrANOS skoru açısından anlamlı fark vardı (8,8±3,2'ye karşı 11,6±2,7; p0,001). ROC analizi ile BrANOS için eğri altındaki alan 0,733 olarak saptandı. BrANOS değerinin >14 olması %100 doğrulukla mortaliteyi öngördü. Nörolojik sekelsiz tüm hastalar onun altında BrANOS değerine sahipti. BrANOS değeri ile GSS istatiksel olarak ilişkili bulundu (p0,001). Arrest sonrası 24 saat hayatta kalan hastalarda iki yıllık yaşam beklentisi ise %31'di. Sonuç: Bu çalışma BrANOS'un kardiyak arrest sonrası prognozun tahminde güvenilir veriler sağladığını göstermiştir