Splenic and Portal Vein Thrombosis after Splenectomy: A Case Report

Portal and splenic vein thrombosis are uncommon, potentially fatal post-operative complications following splenectomy. These thrombotic events may be asymptomatic or present with non-specific symptoms. Therefore, imaging is important for diagnosis. The risk of thrombosis is linked to spleen size, pre-operative thrombocytopenia and surgical technique. We present the case of a 40-year-old man who underwent curative and diagnostic laparotomic splenectomy following chronic thrombocytopenia and concurrent splenomegaly who subsequently developed extensive portal and splenic vein thrombosis. Teaching Point: Portal and splenic vein thrombosis after splenectomy is a relatively uncommon but important diagnosis in which radiology has a pivotal role

An Avoidable Cognitive Error in Chest Radiography

Teaching Point: Awareness in radiology reporting of cognitive errors such as the alliterative bias can help minimize the delay to diagnosis and accelerate adequate patient care

High spectral and spatial resolution X-ray transmission radiography and tomography using a Color X-ray Camera

High resolution X-ray radiography and computed tomography are excellent techniques for non-destructive characterization of an object under investigation at a spatial resolution in the micrometer range. However, as the image contrast depends on both chemical composition and material density, no chemical information is obtained from this data. Furthermore, lab-based measurements are affected by the polychromatic X-ray beam, which results in beam hardening effects. New types of X-ray detectors which provide spectral information on the measured X-ray beam can help to overcome these limitations. In this paper, an energy dispersive CCD detector with high spectral resolution is characterized for use in high resolution radiography and tomography, where a focus is put on the experimental conditions and requirements of both measurement techniques

Audit on Compliance to Guidelines in CT Scanning for Urolithiasis

Introduction: According to the ALARA principle, CT-imaging procedures should be implemented to optimize radiation doses. The purpose of this study is to determine whether a quality control process has an impact on compliance with procedures. Materials and methods: This retrospective study was conducted in three hospitals, focusing on the selection of the appropriate acquisition protocol and the reduction of acquisition height in abdominal computed tomography (CT) examinations performed to diagnose or rule out urolithiasis. A first audit was conducted to measure the compliance with the procedure. Next, a reminder of the CT-urolithiasis procedure was given to stakeholders. Three months later, a second audit was conducted to measure the impact of the repeat recall information on compliance, and to compare the outcome with an earlier audit conducted five years earlier. Results: We included 517 ‘urolithiasis CT examinations’. The compliance ranged from 41.67% to 64.8% for the first audit. After the reminder of the urolithiasis procedure, compliance ranged from 50% to 76.10%. This improvement was statistically significant for hospital A and B (p < 0.001 for hospital A, p = 0.013 for hospital B) but not for hospital C (p = 0.405). Despite prior demonstration that improved compliance persisted at one year from an initial audit, our actual data show that this compliance had decreased at year five, confirming the need to repeat compliance audits more frequently, or to monitor it continuously. Conclusion: Surveying compliance to procedures can improve compliance but only for a limited duration. Monitoring compliance more frequently or even continuously is recommended

Reject Analysis in Digital Radiography and Computed Tomography: A Belgian Imaging Department Case Study

Objective: Reject analysis is usually performed in digital radiography (DR) for quality assurance. Data for computed tomography (CT) rejects remains sparse. The aim of this study is to help provide a straightforward benchmark for reject analysis of both DR and CT. Materials and methods: This retrospective observational study included 107,277 DR and 20,659 CT during 18 months in a tertiary care center. Rejected acquisitions were retrieved by Dose Archiving and Communication System (DACS). The DR and CT reject analysis included reject rates, reasons for rejection and supplementary radiation dose associated with these rejects. Results: 8,904 rejected DR and 514 rejected CT were retrieved. The DR reject rate was 8.3% whereas the CT reject rate was 2.5%. The cumulative effective dose (ED) of DR rejects was 377.3 mSv while the cumulative ED of CT rejects was 1267.4 mSv. The major reason for rejects was positioning for both DR (61%) and CT (44%). Conclusion: This study helps constitute a simple reproducible method to analyze both DR and CT rejects simultaneously. Although CT rejects are less often monitored than DR rejects, the radiation dose associated with CT rejects is much higher, which emphasizes the need to systematically monitor both DR and CT rejects. Investigating the reasons and the most frequently rejected examinations gives an opportunity for improvement of imaging techniques in cooperation with technologists

A Prospective, Real-World, Multinational Study of Naloxegol for Patients with Cancer Pain Diagnosed with Opioid-Induced Constipation—The NACASY Study

Cancer pain; Naloxegol; Ppioid-induced constipationDolor por cáncer; Naloxegol; Estreñimiento inducido por opioidesDolor per càncer; Naloxegol; Restrenyiment induït per opioidesThe Naloxegol Cancer Study (NACASY) was a multinational European study aimed to evaluate the 4-week safety and efficacy of naloxegol in a real-world setting in patients with cancer pain diagnosed with opioid-induced constipation. The primary safety endpoint was the incidence of adverse events leading to study discontinuation. We recruited 170 patients who received at least one dose of naloxegol (i.e., safety population). Out of 170 patients, 20 (11.8%, 95%CI 6.9–16.6) discontinued the study due to adverse events, and, of them, 12 (7.1%, 95%CI 3.2–10.9%) were study discontinuations due to naloxegol-related adverse events. From 76 patients subjects who had completed both 4 weeks of treatment and 28 days of the diary, 55 patients (72.4%, 95% CI 62.3–82.4%) were regarded as responders (i.e., showed ≥3 bowel-movements per week and an increase of ≥1 bowel-movement over baseline) to naloxegol treatment. The Patient Assessment of Constipation—Quality of Life Questionnaire total score and all its subscales improved from baseline to 4 weeks of follow up. Our findings support and provide new evidence about the beneficial effect of naloxegol in terms of improvement of constipation and quality-of-life in patients with cancer-related pain and opioid-induced constipation and show a safety profile consistent with previous pivotal and real-world studies.This project was funded by Kyowa Kirin International. Role of the funding source: The funder of the study and its employees and assignees were involved in study design, data collection, data analysis, data interpretation, and writing of all related reports and publications

Антицитрулінові антитіла в діагностиці артритів у дітей

Віходячи з проведеного дослідження, описаного в роботі, можна дійти висновку, що серед дітей із різними формами артритів тільки 4,8% пацієнтів були серопозитивними за РФ, та 23,8% дітей – за рівнем АЦЦП. Прогнастичне значення підвищеного рівня АЦЦП у дітей із РеА полягає в високій вірогідності розвитку ЮРА, що обумовлює більш ретельне їх спостереження із застосуванням індивідуальних схем профілактичного лікування. При цитуванні документа, використовуйте посилання http://essuir.sumdu.edu.ua/handle/123456789/1128

Radiation dose management in thoracic CT: an international survey

PURPOSEWe aimed to examine current practice patterns of international thoracic radiologists regarding radiation dose management in adult thoracic computed tomography (CT) examinations. MATERIALS AND METHODSAn electronic questionnaire was sent to 800 members of five thoracic radiology societies in North America, Europe, Asia, and Latin America addressing radiation dose training and education, standard kVp and mAs settings for thoracic CT, dose reduction practices, clinical scenarios, and demographics. RESULTSOf the 800 radiologists, 146 responded to our survey. Nearly half (66/146, 45% [95% confidence interval, 37%–53%]) had no formal training in dose reduction, with “self-study of the literature” being the most common form of training (54/146, 37% [29%–45%]). One hundred and seventeen (80% [74%–87%]) had automatic exposure control, and 76 (65% [56%–74%]) used it in all patients. Notably, most respondents (89% [84%–94%]) used a 120 to 125 kVp standard setting, whereas none used 140 kVp. The most common average dose-length-product (DLP) value was 150 to 249 mGy.cm (75/146, 51% [43%–59%]), and 59% (51%–67%) delivered less than 250 mGy.cm in a 70 kg patient. There was a tendency towards higher DLP values with multidetector-row CT. Age, gender, and pregnancy were associated more with dose reduction than weight and clinical indication. CONCLUSIONEfforts for reducing patient radiation dose are highly prevalent among thoracic radiologists. Areas for improvement include reduction of default tube current settings, reduction of anatomical scan coverage, greater use of automatic exposure control, and eventually, reduction of current reference dose values. Our study emphasizes the need for international guidelines to foster greater conformity in dose reduction by thoracic radiologists

Variability and Action Mechanism of a Family of Anticomplement Proteins in Ixodes ricinus

Background: Ticks are blood feeding arachnids that characteristically take a long blood meal. They must therefore counteract host defence mechanisms such as hemostasis, inflammation and the immune response. This is achieved by expressing batteries of salivary proteins coded by multigene families. Methodology/Principal Findings: We report the in-depth analysis of a tick multigene family and describe five new anticomplement proteins in ixodes ricinus. Compared to previously described Ixodes anticomplement proteins, these segregated into a new phylogenetic group or subfamily. These proteins have a novel action mechanism as they specifically bind to properdin, leading to the inhibition of C3 convertase and the alternative complement pathway. An excess of non-synonymous over synonymous changes indicated that coding sequences had undergone diversifying selection. Diversification was not associated with structural, biochemical o, functional diversity, adaptation to host species or stage specificity but rather to differences in antigenicity. Conclusion/Significance: Anticomplement proteins from I. ricinus are the first inhibitors that specifically target a positive regulator of complement, properdin. They may provide new tools for the investigation of role of properdin in physiological and pathophysiological mechanisms. They may also be useful in disorders affecting the alternative complement pathway, Looking for and detecting the different selection pressures involved will help in understanding the evolution of multigene families and hematophagy in arthropods. © 2008 Couveur et al.Journal ArticleResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe