An Unusual Case of Adrenal Metastasis from Colorectal Cancer: Computed Tomography and Fluorine 18-Fluoro-Deoxy-Glucose Positron Emission Tomography-Computed Tomography Features and Literature Review

Incidentally discovered adrenal masses are a common diagnostic problem. While computed tomography (CT) and magnetic resonance (MR) imaging can adequately characterize most benign or malignant adrenal masses, in some cases the results are indeterminate. We report and discuss a case of an adrenal metastasis with misleading clinical and CT features, in which an abnormal metabolic uptake detected through fluorine 18-fluoro-deoxy-glucose positron emission tomography (18F-FDG PET)-CT raised the suspicion of adrenal metastasis relatively early compared with apparently normal results on repeated follow-up CT examinations

Modelled agroforestry outputs at field and farm scale to support biophysical and environmental assessments

This report, comprising Deliverable 6.17, in the AGFORWARD project brings together examples of modelled outputs at field and farm scale to support the biophysical, social, and environmental assessment of the innovations selected from work-packages 2 to 5.N/

Ready, steady, learn: school readiness and children’s voices in English early childhood settings

Internationally, school readiness is increasingly the rationale for early childhood education and care. This is the case in England, yet the statutory English Early Years Foundation Stage framework for children 0-5 years also requires practitioners to listen to children’s voices: discourse indicates dissonance between school readiness and listening to children’s voices so this paper discusses an intrinsic case study that investigated beliefs and practices of 25 practitioners in the English midlands regarding school readiness and listening to children’s voices. In survey responses and semi-structured interviews, practitioners indicated they listen to – and act on – children’s voices but are confused about school readiness; their beliefs and practices align more strongly with social pedagogy than pre-primary schoolification. Findings carry messages for policymakers regarding the need for coherent policy concerning the purpose of early childhood education and care, with practitioner training and a framework aligned fully with that policy. A larger study is indicated

Frequency of musculoskeletal symptoms in diagnostic medical sonographers. Results of a pilot survey

INTRODUCTION: We report the results of a pilot survey in diagnostic medical sonographers. Aim of the study was to evaluate the frequency of musculoskeletal disorders in sonologists and the relationship of these symptoms to ergonomic factors. MATERIALS AND METHODS: 340 sonographers (258 male, 82 female doctors; mean age 41.5 +/- 7.2 years) were given a questionnaire to fill out. The questionnaire asked questions about the sonologist's age, gender, technique of ultrasound procedure, physical activity, and work-related musculoskeletal complaints. Two symptom lists regarded carpal tunnel syndrome (CTS) symptoms (8 items) and other work-related musculoskeletal symptoms (13 items). The categorized response variables "have now" or "in the past" were provided. The symptoms experienced were categorized into three levels as no symptoms, few symptoms (1-4 symptoms), and many symptoms (> 5 symptoms). RESULTS: One third of the respondents reported having at least one or more work-related symptoms in the upper extremities. The most frequent symptoms were tingling (17.6%), numbness or finger pain (13.5%). Carpal tunnel syndrome had been diagnosed in 5 cases (1.5%). More than 60% of all respondents have experienced one or more musculoskeletal symptoms in the cervical or lumbar spine. The commonest symptom was neck and low back pain (67%). The pain was generally intermittent and occurred at the end of the workday. Motion impairment in the neck and/or back was present in 23.5% of cases. Twenty-five percent of respondents had received treatments for their symptoms and 10% reported having stopped work because of their symptoms. Data analysis showed that muscular efforts such as gripping the transducer, applying sustained pressure, and scanning with a correlated flexed or hyperextended wrist were significantly correlated with increasing severity of symptoms in the hand, wrist, and forearm area. On the other hand, low back pain appeared to be negatively correlated with correct position of the body. CONCLUSIONS: Several physical risk factors (e.g., repetitive work and force exertion, twisting of the body and poorly-adjustable chairs) have been identified for work-related upper extremity and spine disorders. Ergonomic redesign of the workstation configuration as well as allowing sufficient recovery time to body and arm muscles appear to be the main goals to achieve prevention of musculoskeletal disorders in sonographers

Diagnostica per immagini nella patologia dell'apparato urogenitale

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Transrectal ultrasonography (TRUS) assessment of cervical cancer response to neoadjuvant therapies

To determine the accuracy of TRUS in evaluating the invasive cervical carcinoma response to neoadjuvant therapies. Thirty-eight patients with locally advanced squamous cell carcinoma (IB bulky-IIIB), before and after 2 cycles of systemic chemotherapy (23 pts) or concurrent chemotherapy and radiation therapy (15 pts) where examined with TRUS evaluating this parameters cervix volume, vaginal and parametrial involvement, bladder and rectal wall invasion. Imaging data were compared to findings of clinical examination (CE) and MR imaging; post-treatment and pre-treatment images were evaluated to assess the tumor response and the results were compared to histopathologic results of resected hysterectomy specimens. Pre-treatment results showed, in local staging, a substantial agreement between TRUS and MR, but not between CE and imaging procedures. Post-treatment, a statistically significant (p<0.001) decrease of the cervix volume, confirmed by histologic findings was detected diagnostic accuracy of TRUS in estimating vaginal and parametrial involvement was 81% and 86%. TRUS demonstrated an high accuracy in evaluation of tumor response, however, in same cases vaginal and parametrial involvement was overestimated