Incidental CT Findings in the Elderly with Low-Energy Falls: Prevalence and Implications

Background: Computed tomography (CT) is commonly used in trauma care, with increasing implementation during the emergency work-up of elderly patients with low-energy falls (LEF). The prevalence of incidental findings (IFs) resulting from CT imaging and requiring down-stream actions in this patient cohort is unknown. We have investigated the prevalence and urgency of IFs from emergency CT examinations in these patients. Methods: A total of 2871 patients with LEF and emergency CT examinations were consecutively included in this retrospective cohort study. The primary endpoint was the prevalence of IFs;the secondary endpoint was their urgency. Results: The median age was 82 years (64.2% were women). IFs were identified in 73.9% of patients, with an average of 1.6 IFs per patient. Of all IFs, 16.4% were classified as urgent or relevant, predominantly in the abdomen, chest and neck. Increasing age was associated with the prevalence of an IF (odds ratio: 1.053, 95% confidence interval: 1.042-1.064). Significantly more IFs were found in female patients (75.2% vs. 71.5%). Conclusion: IFs resulting from CT examinations of the elderly are frequent, but in more than 8 out of 10, they are harmless or currently asymptomatic. For the benefit of an accurate diagnosis of traumatic lesions, concerns about IFs with respect to disease burden, further work-up and resource utilisation might be disregarded

Levels, sources and chemical fate of persistent organic pollutants in the atmosphere and snow along the western Antarctic Peninsula

The Antarctic continent is among the most pristine regions; yet various organic contaminants have been measured there routinely. Air and snow samples were collected during the austral spring (October November, 2010) along the western Antarctic Peninsula and analyzed for organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) to assess the relative importance of long-range transport versus local primary or secondary emissions. Highest concentrations of PCBs, PBDEs and DDTs were observed in the glacier\u27s snow sample, highlighting the importance of melting glaciers as a possible secondary source of legacy pollutants to the Antarctic. In the atmosphere, contaminants were mainly found in the vapor phase (\u3e65%). Hexachlorobenzene (33.6 pg/m(3)), PCBs (11.6 pg/m(3)), heptachlor (5.64 pg/m(3)), PBDEs (4.22 pg/m(3)) and cis-chlordane (2.43 pg/m(3)) were the most abundant contaminants. In contrast to other compounds, PBDEs seem to have originated from local sources, possibly the research station itself. Gas-particle partitioning for analytes were better predicted using the adsorption partitioning model than an octanol-based absorption approach. Diffusive flux calculations indicated that net deposition is the dominant pathway for PBDEs and chlordanes, whereas re-volatilization from snow (during melting or metamorphosis) was observed for PCBs and some OCPs. (C) 2016 Elsevier Ltd. All rights reserved

Management of Antarctic baleen whales amid past exploitation, current threats and complex marine ecosystems

As baleen whales recover from severe exploitation, they are probably subject to a wide variety of threats within the Antarctic marine ecosystem, including directed take. Here we review both the management and current status of Antarctic baleen whales and consider those threats likely to impact on them. Threats range from global problems - marine pollution and climate change - to localized issues including shipping, habitat disturbance, unregulated wildlife tourism and fishery activities. We identify the most pressing anthropogenic threats to baleen whales including scientific whaling and climate change. It is unclear whether current management approaches will be able to effectively encompass all these threats while also accounting both for the differing levels of scientific understanding and for the differing recovery rates of the whale species. For management we recommend the following: 1) incorporation of both ecosystem considerations and the suite of identified threats not limited to direct take, 2) identification of measurable indicators of changes in whales that allow more certainty in monitoring of populations and the environment, and 3) recognition of significant relationships between baleen whales and habitat features to provide information on distribution and use