1
|
Plasencia Martínez JM, García Tuells I, Bravo Pérez C, Blanco Barrio A. Target sign in COVID-19, radiological interpretation and diagnostic contribution of digital thoracic tomosynthesis. Radiologia (Engl Ed) 2024; 66 Suppl 1:S32-S39. [PMID: 38642959 DOI: 10.1016/j.rxeng.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/16/2023] [Indexed: 04/22/2024]
Abstract
INTRODUCTION Our objectives are: To describe the radiological semiology, clinical-analytical features and prognosis related to the target sign (TS) in COVID-19. To determine whether digital thoracic tomosynthesis (DTT) improves the diagnostic ability of radiography. MATERIAL AND METHODS Retrospective, descriptive, single-centre, case series study, accepted by our ethical committee. Radiological, clinical, analytical and follow-up characteristics of patients with COVID-19 and TS on radiography and DTT between November 2020 and January 2021 were analysed. RESULTS Eleven TS were collected in 7 patients, median age 35 years, 57% male. All TS presented with a central nodule and a peripheral ring, and in at least 82%, the lung in between was of normal density. All TS were located in peripheral, basal regions and 91% in posterior regions. TS were multiple in 43%. Contiguous TS shared the peripheral ring. Other findings related to pneumonia were associated in 86% of patients. DTT detected 82% more TS than radiography. Only one patient underwent a CT angiography of the pulmonary arteries, positive for acute pulmonary thromboembolism. Seventy-one per cent presented with pleuritic pain. No distinctive laboratory findings or prognostic worsening were detected. CONCLUSIONS TS in COVID-19 predominates in peripheral and declining regions and can be multiple. Pulmonary thromboembolism was detected in one case. It occurs in young people, frequently with pleuritic pain and does not worsen the prognosis. DTT detects more than 80 % of TS than radiography.
Collapse
Affiliation(s)
| | - I García Tuells
- Servicio de Radiodiagnóstico, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - C Bravo Pérez
- Servicio de Hematología, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Pascual Parrilla, Instituto de Salud Carlos III - CIBERER, Madrid, Spain
| | - A Blanco Barrio
- Servicio de Radiodiagnóstico, Hospital Universitario Morales Meseguer, Murcia, Spain
| |
Collapse
|
2
|
Masuda T, Takei Y, Arao S. Is the use of gonad protection protectors necessary during infants chest radiography? Radiologia (Engl Ed) 2024; 66:107-113. [PMID: 38614527 DOI: 10.1016/j.rxeng.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/21/2022] [Indexed: 04/15/2024]
Abstract
INTRODUCTION AND OBJECTIVES To compare gonad doses with and without a gonad protector and to optimize the use of gonadal protectors in infants thorax radiography. MATERIALS AND METHODS Two pediatric anthropomorphic phantoms are used: an X-ray system for KXO-50SS/DRX-3724HD, and a digital radiography system for CALNEO Smart C12, with and without a gonad protector during infants thorax radiography. A real time skin dosimeter is placed on the X-ray system, and a real time skin dosimeter is inserted on the front side of the mammary gland, the front and back sides of the true pelvis level, and on the ovaries and testes. The X-ray system is irradiated 15 times using phantoms with and without a gonad protector. The measured entrance patient doses values of for the real time skin dosimeter are compared for each phantom, with and without the gonad protector. RESULTS The medium of measured entrance patient doses values for front side dose of the true pelvis level with and without the protector are 10.00 and 5.00 μGy at newborn, and 10.00 and 0.00μGy at one year, respectively. The medium of measured entrance patient doses values for the back side dose of the true pelvis level with and without the protector are 0.00 and 0.00 μGy at both newborn one year, respectively. The measured entrance patient doses cannot be detected in the ovaries and testes with or without the protector. No significant differences are observed in the measured entrance patient doses values for the front and back side doses of the pelvis, ovaries, and testes at newborn and one year, with and without the protector (p>0.05). CONCLUSIONS No significant difference was observed in gonad dose measurements with and without the gonad protector during infants chest radiography. We believe that gonadal protector wearing is not necessary.
Collapse
Affiliation(s)
- T Masuda
- Departamento de Tecnología Radiológica, Facultad de Ciencia y Tecnología de la Salud, Universidad de Bienestar Médico de Kawasaki, Kurashiki, Okayama, Japan.
| | - Y Takei
- Departamento de Tecnología Radiológica, Facultad de Ciencia y Tecnología de la Salud, Universidad de Bienestar Médico de Kawasaki, Kurashiki, Okayama, Japan
| | - S Arao
- Departamento de Tecnología Radiológica, Facultad de Ciencia y Tecnología de la Salud, Universidad de Bienestar Médico de Kawasaki, Kurashiki, Okayama, Japan
| |
Collapse
|
3
|
Suarez-Cabezas S, Sanavia Morán E, García García-Galán A, Álvarez Sánchez AT, Muñoz López C, Pérez-Moneo Agapito B. Peripheral trauma treated in the pediatric emergency department: Descriptive study. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024:S1888-4415(24)00040-7. [PMID: 38246345 DOI: 10.1016/j.recot.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/18/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION Peripheral trauma is a very frequent cause of consultation in paediatric emergency departments but few studies have been published describing the characteristics of these patients. MATERIAL AND METHODS We performed a retrospective descriptive study by reviewing computerised emergency department forms during January and February 2020. OBJECTIVE To describe the characteristics of traumatic injuries in our area and to detect possible areas for improvement. RESULTS A total of 714 peripheral trauma cases were attended, which represents 9.5% of the total consultations. A total of 52.7% were schoolchildren (6-11 years). The most frequent locations were the ankle (27.5%) and fingers (17.2%). Fracture was detected in 6.7% of cases. Radiographs were requested in 78.6% of the patients, with pathological findings in 9.6% of them. Half of the X-rays were requested due to ankle or finger trauma. Referral to traumatology was made in 16.4% of patients, mainly for elbow and knee trauma, and the most commonly used treatment was general measures (49%) and bandaging (29.4%). CONCLUSIONS Peripheral trauma is very common and, in general, banal. A large number of X-rays are requested with a very low yield, so it seems necessary to establish new protocols to reduce the number of requests. Improving training in elbow and knee trauma could improve paediatricians' autonomy in dealing with these more complex injuries.
Collapse
Affiliation(s)
| | | | | | | | - C Muñoz López
- Hospital Universitario Infanta Leonor, Madrid, España
| | | |
Collapse
|
4
|
Choreño-Delgado V. [Comment on article "Correlation between ultrasonography and thorax portable radiography in patients with COVID-19"]. Rev Med Inst Mex Seguro Soc 2023; 61:719. [PMID: 37995200 DOI: 10.5281/zenodo.10064252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/19/2023] [Indexed: 11/25/2023]
Abstract
Point-of-care ultrasound is an emerging tool in critical care areas. In the study we are discussing, the ultrasonographic findings are compared and contrasted with the radiographic ones in patients with COVID-19.
Collapse
Affiliation(s)
- Verónica Choreño-Delgado
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Pediatría, Unidad de Terapia Intensiva. Ciudad de México, México
| |
Collapse
|
5
|
Avelar-Garnica FJ, Reyes-Olhagaray FB, Paredes-Manjarrez C, Arellano-Sotelo J, Luis-Jarquín VM, Miguel-Puga JA, Jáuregui-Renaud K. [Answer to "Comment on article: "Correlation between ultrasonography and thorax portable radiography in patients with COVID-19""]. Rev Med Inst Mex Seguro Soc 2023; 61:720. [PMID: 37995201 DOI: 10.5281/zenodo.10064262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
Science, through scientific research, is an activity that generates new ideas. However, for the construction of new knowledge it is necessary to confront ideas with peers in the scientific world; which is exercised through scientific communication.
Collapse
Affiliation(s)
- Francisco José Avelar-Garnica
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Departamento de Imagenología. Ciudad de México, México
| | - Fernando Bernardo Reyes-Olhagaray
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Departamento de Imagenología. Ciudad de México, México
| | - Carlos Paredes-Manjarrez
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Departamento de Imagenología. Ciudad de México, México
| | - Jorge Arellano-Sotelo
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Departamento de Imagenología. Ciudad de México, México
| | - Viridiana Monserrat Luis-Jarquín
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Especialidades "Dr. Bernardo Sepúlveda Gutiérrez", Departamento de Imagenología. Ciudad de México, México
| | - José Adán Miguel-Puga
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Otoneurología. Ciudad de México, México
| | - Kathrine Jáuregui-Renaud
- Instituto Mexicano del Seguro Social, Unidad de Investigación Médica en Otoneurología. Ciudad de México, México
| |
Collapse
|
6
|
Plasencia-Martínez JM, Pérez-Costa R, Ballesta-Ruiz M, García-Santos JM. Performance in prognostic capacity and efficiency of the Thoracic Care Suite GE AI tool applied to chest radiography of patients with COVID-19 pneumonia. Radiologia (Engl Ed) 2023; 65:509-518. [PMID: 38049250 DOI: 10.1016/j.rxeng.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/28/2022] [Indexed: 12/06/2023]
Abstract
OBJECTIVE Rapid progression of COVID-19 pneumonia may put patients at risk of requiring ventilatory support, such as non-invasive mechanical ventilation or endotracheal intubation. Implementing tools that detect COVID-19 pneumonia can improve the patient's healthcare. We aim to evaluate the efficacy and efficiency of the artificial intelligence (AI) tool GE Healthcare's Thoracic Care Suite (featuring Lunit INSIGHT CXR, TCS) to predict the ventilatory support need based on pneumonic progression of COVID-19 on consecutive chest X-rays. METHODS Outpatients with confirmed SARS-CoV-2 infection, with chest X-ray (CXR) findings probable or indeterminate for COVID-19 pneumonia, who required a second CXR due to unfavorableclinical course, were collected. The number of affected lung fields for the two CXRs was assessed using the AI tool. RESULTS One hundred fourteen patients (57.4±14.2 years, 65-57%-men) were retrospectively collected. Fifteen (13.2%) required ventilatory support. Progression of pneumonic extension ≥0.5 lung fields per day compared to pneumonia onset, detected using the TCS tool, increased the risk of requiring ventilatory support by 4-fold. Analyzing the AI output required 26s of radiological time. CONCLUSIONS Applying the AI tool, Thoracic Care Suite, to CXR of patients with COVID-19 pneumonia allows us to anticipate ventilatory support requirements requiring less than half a minute.
Collapse
Affiliation(s)
| | - R Pérez-Costa
- Servicio de Medicina de Urgencias, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - M Ballesta-Ruiz
- Epidemiología y Salud Pública, Consejería de Salud Regional. IMIB-Arrixaca, Universidad de Murcia, Murcia, Spain
| | - J M García-Santos
- Servicio de Radiología, Hospital General Universitario Morales Meseguer, Murcia, Spain
| |
Collapse
|
7
|
Cardoso A, Ferreira JN, Viegas R, Amaro P, Gamelas P, Alonso R, Pires L. Radiographic evaluation of the bicipital groove morphology does not predict intraarticular changes in the long head of biceps tendon. Radiologia (Engl Ed) 2023; 65 Suppl 2:S3-S9. [PMID: 37858350 DOI: 10.1016/j.rxeng.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 09/30/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION AND OBJECTIVES This study aimed to examine the clinical utility of the radiographic evaluation of the bicipital groove in predicting long head of biceps tendon (LHBT) pathology. MATERIAL AND METHODS A prospective study was conducted, and sixty consecutive patients proposed to shoulder arthroscopic surgery were selected. Before surgery, a radiographic evaluation was performed with a supine and a Fisk radiograph. Most supine radiographs (>75%) were non-interpretable and were excluded from the study. As some Fisk radiographs (26.7%) were also non-interpretable, that left 44 interpretable radiographs in the study. These were measured for medial opening angle, total opening angle, width and depth of the bicipital groove. The radiographic measurements and the presence of LHBT pathology, as assessed at arthroscopy, were correlated. RESULTS Radiographic evaluation of the bicipital groove showed a mean medial opening angle of 53 ± 15° (23-90), a mean total opening angle of 80 ± 26° (30-135), a mean width of 10.3 ± 2.5 mm (6-19) and a mean depth of 4.1 ± 1.5 mm (1-8). Men had higher medial opening angle (60 vs 50°, p = 0.044) and wider grooves (11.9 vs 9.7 mm, p = 0.019). Twenty-five patients (56.8%) were found to have an abnormal LHBT. No correlation was found between the radiographic measurements and LHBT pathology. Only age was correlated with a LHBT lesion (61.8 vs 46.3 years, p < 0.001). CONCLUSIONS Our results show that there is no correlation between radiographic morphologic evaluation of the bicipital groove and LHBT pathology.
Collapse
Affiliation(s)
- A Cardoso
- Hospital Beatriz Angelo, Loures, Portugal.
| | | | - R Viegas
- Hospital Beatriz Angelo, Loures, Portugal
| | - P Amaro
- Hospital Beatriz Angelo, Loures, Portugal
| | - P Gamelas
- Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - R Alonso
- Hospital Beatriz Angelo, Loures, Portugal
| | - L Pires
- Hospital Beatriz Angelo, Loures, Portugal
| |
Collapse
|
8
|
Plasencia Martínez JM. Schematic approach to the diagnosis of multifocal lung opacities in the emergency department. Radiologia (Engl Ed) 2023; 65 Suppl 1:S63-S72. [PMID: 37024232 DOI: 10.1016/j.rxeng.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/21/2022] [Indexed: 04/08/2023]
Abstract
Radiologists in the emergency department must be prepared to deal with any type of disease in any organ at any time. Many entities involving the chest can result in patients' presenting at the emergency department. This chapter deals with entities that manifest with multifocal lung opacities and that can be mistaken for pneumonia. To facilitate their identification, this chapter approaches these entities by considering their most characteristic distribution on chest X-rays, the main diagnostic modality used for thoracic problems in the emergency department. Our schematic approach includes the key findings in patients' personal histories, clinical examination, laboratory tests, and imaging studies that can be available during the initial workup.
Collapse
|
9
|
Blanco-Barrio A, Moreno-Pastor A, Lozano-Ros M. Fractures of the limbs: basic concepts for the emergency department. Radiologia (Engl Ed) 2023; 65 Suppl 1:S42-S52. [PMID: 37024230 DOI: 10.1016/j.rxeng.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/05/2022] [Indexed: 04/08/2023]
Abstract
Traumatic injuries of the limbs are very common and account for a large number of imaging examinations, especially in emergency departments. These injuries can often be resolved if they are recognized and treated appropriately. Their diagnosis requires a complete clinical assessment and the correct interpretation of the appropriate imaging tests. Radiologists play an important role, especially in diagnosing lesions that can go undetected. To this end, radiologists need to know the normal anatomy and its variants, the mechanisms of injury, and the indications for different imaging tests, among which plain-film X-rays are the main technique for the initial evaluation. This article aims to review the relevant characteristics of limb fractures in adults and of lesions that can be associated with these fractures, as well as how to describe them to ensure appropriate clinical management.
Collapse
Affiliation(s)
- A Blanco-Barrio
- Servicio de Radiodiagnóstico, Sección Radiología de Urgencias, Hospital Universitario Morales Meseguer, Murcia, Spain.
| | - A Moreno-Pastor
- Servicio de Radiodiagnóstico, Sección Radiología de Urgencias, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - M Lozano-Ros
- Servicio de Radiodiagnóstico, Sección Radiología de Urgencias, Hospital Universitario Morales Meseguer, Murcia, Spain
| |
Collapse
|
10
|
Rivera-Saldívar G, Alcántara-Corona A, Torres-Gonzalez R, Amaya-Zepeda R, Tecualt-Gómez R, Cario-Méndez A. Asociación entre las características radiográficas y los tumores óseos de rodilla. CIR CIR 2023; 91:15-20. [PMID: 36787609 DOI: 10.24875/ciru.21000857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND Bone neoplasms require an adequate clinical-radiographic evaluation for their diagnosis. Plain radiographs are the usual method to establish the diagnosis and evaluate differential diagnoses in the study of bone tumor pathology. OBJECTIVE To recognize the frequency of radiographic characteristics and associate them with bone tumor pathology. METHOD Radiographic data were collected from 132 patients with tumor pathology confirmed by biopsy from bone tumors service of the Traumatology and Orthopedics Hospital Unidades Médicas de Alta Especialidad Dr. Victorio de la Fuente Narváez, Instituto Mexicano del Seguro Social, Ciudad de México, during 2019. RESULTS 132 patients were registered. The most frequent benign tumor was osteochondroma (27.3%), and malignant was osteosarcoma (9.8%). Active lytic lesions (odds ratio [OR]: 6.9; 95% confidence interval [95% CI]: 2.83-16.85) or aggressive (OR: 26.85; 95% CI: 3.21-224) were associated with giant cells tumors. Poorly differentiated intraosseous blast lesions of bone lineage (OR: 36.15; 95% CI: 4.4-295.5) were associated with osteosarcoma. The periosteal reaction (OR: 36.15; 95% CI: 4.4-295.5), the moth-eaten or permeative pattern (OR: 11.75; 95% CI: 1.26-109) and the central location of the lesion (OR: 3.03; 95% CI: 1.37-6.69) were associated with malignant tumor lesions. CONCLUSIONS Poorly defined intraosseous blast lesions of bone lineage, periosteal reaction, and moth-eaten or permeative pattern of destruction are associated with malignant lesions.
Collapse
Affiliation(s)
| | | | - Rubén Torres-Gonzalez
- Coordinación de Educación e Investigación en Salud. Unidades Médicas de Alta Especialidad Dr. Victorio de la Fuente Narváez, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | | | | |
Collapse
|
11
|
Ruta S, Sanchez Prado E, Salvatori F, Arguello J, Aguerre D, Magri S, García Salinas R. Ultrasound tenosynovitis: A differential feature of patients with seronegative rheumatoid arthritis. Reumatol Clin (Engl Ed) 2023; 19:63-6. [PMID: 36739120 DOI: 10.1016/j.reumae.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/04/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To identify differential features between patients with seropositive and seronegative rheumatoid arthritis (RA). METHOD Prospective cohort study, including patients who were admitted for polyarthralgia. At baseline was performed: laboratory studies, X-rays of hands and feet, ultrasound of both hands with power Doppler technique, clinical data and clinimetry. In subsequent visits the definitive diagnosis of RA was established or not. It was considered as seronegative RA when patients were negative for both RF and ACPAs. RESULTS 746 patients were included, of which 128 (17.1%) ended with a final diagnosis of RA. Of these 128 patients, 87 (67.9%) were seropositive RA, while 41 (32%) were seronegative RA. The only feature that showed significant differences was the presence of tenosynovitis detected by ultrasound with a positive power Doppler signal, 13.7% of the patients with seropositive RA vs 41.6% of the patients with seronegative RA (p=0.0028). CONCLUSION The only differential feature of patients with seronegative RA was the higher proportion of tenosynovitis detected by ultrasound.
Collapse
|
12
|
Rivera-Saldívar G, Torres-González R, Cario-Méndez A, Técualt-Gómez R, Amaya-Zepeda RA, Alcántara-Corona A, Fuentes-Figueroa S. MSH-5: malignant knee tumors timely detection index. CIR CIR 2023; 91:146-152. [PMID: 37084299 DOI: 10.24875/ciru.21000907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
BACKGROUND Bone neoplasms are usually misdiagnosed causing a delay in their treatment. Bone neoplasms are usually confused with tendinitis, 31% of the cases corresponds to osteosarcomas and in 21% to Ewing's sarcomas. OBJECTIVE To create a clinical-radiographic instrument of high diagnostic suspicion of knee bone neoplasms to prevent a delay in diagnosis. METHOD A clinimetric study (sensitivity, consistency and validity) was performed in the bone tumor service, Hospital de Ortopedia de la Unidad Médica de Alta Especialidad Dr. Victorio de la Fuente Narváez, Instituto Mexicano del Seguro Social, in México City. RESULTS Characteristics of 153 patients were collected. For the sensitivity phase, 3 domains (signs, symptoms, and radiology) and 12 items were included. Consistency was evaluated with ICC (0.944), 95%CI (0.865-0.977), p < 0.001 and a-Cronbach (0.863). Index obtained a sensitivity of 0.80 and a specificity of 0.882 were obtained. The positive predictive value of the test was 66.6% and the negative predictive value was 93.75%. The positive likelihood ratio was 6.8 and the negative likelihood ratio was 0.2. Validity was evaluated using r-Pearson (0.894; p < 0.001). CONCLUSIONS A high suspicion clinical-radiographic index was designed to detect malignant knee tumors with adequate sensitivity, specificity, appearance, content, criteria, and construct validity.
Collapse
Affiliation(s)
| | - Rubén Torres-González
- Coordinación de Educación e Investigación en Salud. Unidad Médica de Alta Especialidad Dr. Victorio de la Fuente Narváez, Instituto Mexicano del Seguro Social, Ciudad de México, México
| | | | | | | | | | | |
Collapse
|
13
|
Gaytán-Fernández S, Barragán-Hervella RG, Quiroz-Williams J, Valle-Cortés EMD, Castillo-Ramírez IO, Montiel-Jarquín ÁJ. Timely radiographic detection of developmental dysplasia of the hip in family medicine residents. Educative intervention. CIR CIR 2023; 91:703-708. [PMID: 37844899 DOI: 10.24875/ciru.21000797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/14/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Developmental dysplasia of the hip (DDH) is a complex clinical entity that is usually underdiagnosed, if not detected and managed early, will turn the affected individual into a disabled being, with negative social, economic and emotional effects. OBJECTIVE To determine the capacity for the timely radiographic detection of DDH before and after an educational intervention. METHOD An educational intervention is carried out in family medicine resident, where they are given training on detection in DDH radiographic projections. Pre- and post-training evaluation is carried out. Statistical analysis is performed using Student's t and χ2, taking p ≤ 0.05 as significant. RESULTS 94 residents participated. In the pre-intervention evaluation, 87.2% had no knowledge of the early detection protocol (p = 0.525). It was observed that 98.9% incorrectly drew the Perkins line (p = 0.427), 96.8% the Hilgenreiner line (p = 0.177) and 87.2% did not consider the data of bilateral dysplasia (p = 0.956). After the educational intervention, 87.2% correctly drew the Perkins line (p = 0.926), 97.8% the Hilgenreiner line (p = 0.325) and 78.7% if they considered the data of bilateral dysplasia (p = 0.826). CONCLUSIONS After this training, 80% of family medicine residents were able to detect DDH in a timely manner.
Collapse
Affiliation(s)
- Suemmy Gaytán-Fernández
- Unidad Médica de Alta Especialidad, Hospital de Traumatología y Ortopedia Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS)
| | - Rodolfo G Barragán-Hervella
- Unidad Médica de Alta Especialidad, Hospital de Traumatología y Ortopedia Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS)
| | - Jorge Quiroz-Williams
- Unidad Médica de Alta Especialidad, Hospital de Traumatología y Ortopedia Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS)
| | - Evelyn M Del Valle-Cortés
- Unidad Médica de Alta Especialidad, Hospital de Traumatología y Ortopedia Manuel Ávila Camacho, Instituto Mexicano del Seguro Social (IMSS)
| | - Isabel O Castillo-Ramírez
- Facultad de Medicina, Programa de Servicio Social en Investigación en Salud, Universidad Popular Autónoma del Estado de Puebla
| | - Álvaro J Montiel-Jarquín
- Unidad Médica de Alta Especialidad, Hospital de Especialidades Manuel Ávila Camacho, IMSS. Puebla, Puebla, México
| |
Collapse
|
14
|
Sánchez-Oro R, Torres Nuez J, Fatahi Bandpey ML, Martínez-Sanz G. Marie Curie: How to break the glass ceiling in science and in radiology. Radiologia (Engl Ed) 2021; 63:456-465. [PMID: 34625201 DOI: 10.1016/j.rxeng.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022]
Abstract
Marie Curie was born in Warsaw in1867. She graduated first in her class in her undergraduate programs in physics and mathematics at Sorbonne University, and she was one of the first women to earn a PhD. She was the first woman to win a Nobel prize (in physics, together with her husband, Pierre Curie), and she was also the first person to win a second Nobel prize in another category (chemistry). Her life is an example of dedication to science based on altruism, personal growth, and tenacity. Being the first woman to break through so many barriers in a totally male-dominated science makes her an emblematic figure in the fight for equal opportunities and human rights. This article reviews her most important contributions to science in general and to diagnostic radiology in particular through her participation in the French military's radiological plan during the First World War.
Collapse
Affiliation(s)
- R Sánchez-Oro
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, Spain.
| | - J Torres Nuez
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, Spain
| | - M L Fatahi Bandpey
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, Spain
| | - G Martínez-Sanz
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, Spain
| |
Collapse
|
15
|
Ramos Rodríguez R, Rozas Quintanilla JP, Nava Baro E, Sendra Portero F. Mónico Sánchez Moreno: a pioneer in radiologic technology. Radiologia (Engl Ed) 2021; 64:S0033-8338(21)00115-6. [PMID: 34332785 DOI: 10.1016/j.rx.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/04/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Abstract
Mónico Sánchez Moreno (1880-1961) was an important figure in the early years of electromedicine, rubbing elbows with world-class physicists like Nikola Tesla. Her main contribution to the field was the invention and commercialization of a portable X-ray generator, replacing the heavy transformer had been necessary to generate power with a lightweight portable device that could work with direct or alternating current at 220 or 125V. This device was easily adaptable to other applications in electromedicine, such as cauterization or disinfection. This indefatigable entrepreneur could have triumphed in America, but preferred to work toward furthering technological development in the land that she loved. Her efforts made it possible to have an affordable device made in Spain that would allow radiological examinations to be done in places where it would have been otherwise unthinkable. In conclusion, Mónico Sánchez Moreno was a self-made woman who deserves to be remembered for her pioneering role in portable radiology.
Collapse
Affiliation(s)
| | - J P Rozas Quintanilla
- Escuela Superior de Informática de Ciudad Real, Universidad de Castilla la Mancha, España
| | - E Nava Baro
- Departamento de Ingeniería de Comunicaciones, ETSI de Ingeniería de Telecomunicaciones, Málaga, España
| | - F Sendra Portero
- Departamento de Radiología y Medicina Física, Facultad de Medicina, Málaga, España.
| |
Collapse
|
16
|
Sempere-González A, Llaneras-Artigues J, Pinal-Fernández I, Cañas-Ruano E, Orozco-Gálvez O, Domingo-Baldrich E, Michelena X, Meza B, García-Vives E, Gil-Vila A, Sarrapio-Lorenzo J, Romero-Ruperto S, Sanpedro-Jiménez F, Arranz-Betegón M, Fernández-Codina A. Radiography-based triage for COVID-19 in the Emergency Department in a Spanish cohort of patients. Med Clin (Barc) 2021; 158:466-471. [PMID: 34256936 PMCID: PMC8206616 DOI: 10.1016/j.medcli.2021.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Strategies to determine who could be safely discharged home from the Emergency Department (ED) in COVID-19 are needed to decongestion healthcare systems. OBJECTIVES To describe the outcomes of an ED triage system for non-severe patients with suspected COVID-19 and possible pneumonia based on chest X-ray (CXR) upon admission. MATERIAL AND METHODS Retrospective, single-center study performed in Barcelona (Spain) during the COVID-19 peak in March-April 2020. Patients with COVID-19 symptoms and potential pneumonia, without respiratory insufficiency, with priority class IV-V (Andorran triage model) had a CXR upon admission. This approach tried to optimize resource use and to facilitate discharges. The results after adopting this organizational approach are reported. RESULTS We included 834 patients, 53% were female. Most patients were white (66%) or Hispanic (27%). CXR showed pneumonia in 523 (62.7%). Compared to those without pneumonia, patients with pneumonia were older (55 vs 46.6 years old) and had a higher Charlson comorbidity index (1.9 vs 1.3). Patients with pneumonia were at a higher risk for a combined outcome of admission and/or death (91 vs 12%). Death rates tended to be numerically higher in the pneumonia group (10 vs 1). Among patients without pneumonia in the initial CXR, 10% reconsulted (40% of them with new pneumonia). CONCLUSION CXR identified pneumonia in a significant number of patients. Those without pneumonia were mostly discharged. Mortality among patients with an initially negative CXR was low. CXR triage for pneumonia in non-severe COVID-19 patients in the ED can be an effective strategy to optimize resource use.
Collapse
Affiliation(s)
| | | | - Iago Pinal-Fernández
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MA, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA; Faculty of Health Sciences and Faculty of Computer Science, Multimedia and Telecommunications, Universitat Oberta de Catalunya, Barcelona, Spain
| | | | | | | | - Xabier Michelena
- Emergency Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Beatriz Meza
- Emergency Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Eloi García-Vives
- Emergency Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Albert Gil-Vila
- Emergency Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | | | | | - Andreu Fernández-Codina
- Emergency Department, University Hospital Vall d'Hebron, Barcelona, Spain; Rheumatology Division and General Internal Medicine Division-Windsor Campus, University of Western Ontario, London/Windsor, ON, Canada.
| |
Collapse
|
17
|
Sánchez-Oro R, Torres Nuez J, Fatahi Bandpey ML, Martínez-Sanz G. Marie Curie: how to break the glass ceiling in science and in radiology. Radiologia 2021. [PMID: 34088535 DOI: 10.1016/j.rx.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Marie Curie was born in Warsaw in1867. She graduated first in her class in her undergraduate programs in physics and mathematics at Sorbonne University, and she was one of the first women to earn a PhD. She was the first woman to win a Nobel prize (in physics, together with her husband, Pierre Curie), and she was also the first person to win a second Nobel prize in another category (chemistry). Her life is an example of dedication to science based on altruism, personal growth, and tenacity. Being the first woman to break through so many barriers in a totally male-dominated science makes her an emblematic figure in the fight for equal opportunities and human rights. This article reviews her most important contributions to science in general and to diagnostic radiology in particular through her participation in the French military's radiological plan during the First World War.
Collapse
Affiliation(s)
- R Sánchez-Oro
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España.
| | - J Torres Nuez
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España
| | - M L Fatahi Bandpey
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España
| | - G Martínez-Sanz
- Servicio de Radiodiagnóstico, Hospital General de Teruel Obispo Polanco, Teruel, España
| |
Collapse
|
18
|
Capdevila-Reniu A, Navarro-López M, López-Soto A. Osteoporotic vertebral fractures: A diagnostic challenge in the 21 ST century. Rev Clin Esp 2021; 221:118-124. [PMID: 31810559 DOI: 10.1016/j.rce.2019.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/08/2019] [Accepted: 09/05/2019] [Indexed: 10/25/2022]
Abstract
Vertebral fractures are the most prevalent osteoporotic fractures and are paradoxically the most underdiagnosed. While only one-third of patients have acute pain, they can present other associated chronic complications. Vertrebal fractures are associated with the onset of new fractures, both vertebral and nonvertebral. Radiography of the dorsal-lumbar spine is a useful tool for detecting them but depends on the subjective interpretation of the physician conducting the assessment. New techniques, such as vertebral morphometry, have recently demonstrated greater efficacy in detecting v vertebral fractures and are performed concomitantly with bone densitometry. Knowing how to identify vertebral fractures is essential for the secondary prevention of new fractures and improving our patients' quality of life.
Collapse
Affiliation(s)
- A Capdevila-Reniu
- Servicio de Medicina Interna, Unidad de Geriatría, Hospital Clínic de Barcelona, Barcelona, España.
| | - M Navarro-López
- Servicio de Medicina Interna, Unidad de Geriatría, Hospital Clínic de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, España
| | - A López-Soto
- Servicio de Medicina Interna, Unidad de Geriatría, Hospital Clínic de Barcelona, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, España
| |
Collapse
|
19
|
Aguilar-Gisbert L, Santos-Pérez de la Blanca R, Peña-Vallejo E. [Urinary stone imaging tests.]. ARCH ESP UROL 2021; 74:24-34. [PMID: 33459619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Imaging in urolithiasis has a wide group of techniques, with different characteristics, limitations, and indications, which together allow the management of this prevalent pathology. Plain abdominal radiography and ultrasound are very accessible and in expensive techniques that combined present an acceptable sensitivity and specificity. They are widely used for monitoring the evolution of stone disease and for evaluation after treatments (surgery or SWL). Ultrasound is the primary radiological diagnostic tool in the pediatric population and in pregnant women. CT has prevailed over IVP in the anatomical assessment of the urinary tract and the description of the characteristics of the lithiasis, although it shows a greater exposure to ionizing radiation, so the use of low and ultra-low dose CT is spreading. In this article we also discuss other imaging techniques suchas Digital to mosynthesis, Fluoroscopy and DMSA Scintigraphy.
Collapse
Affiliation(s)
| | | | - Elena Peña-Vallejo
- Servicio de Urología. Hospital Universitario 12 de Octubre. Madrid. España
| |
Collapse
|
20
|
Cardoso A, Ferreira JN, Viegas R, Amaro P, Gamelas P, Alonso R, Pires L. Radiographic evaluation of the bicipital groove morphology does not predict intraarticular changes in the long head of biceps tendon. Radiologia (Engl Ed) 2020; 65:S0033-8338(20)30162-4. [PMID: 33334591 DOI: 10.1016/j.rx.2020.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 08/27/2020] [Accepted: 09/30/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION AND OBJECTIVES This study aimed to examine the clinical utility of the radiographic evaluation of the bicipital groove in predicting long head of biceps tendon (LHBT) pathology. MATERIAL AND METHODS A prospective study was conducted, and sixty consecutive patients proposed to shoulder arthroscopic surgery were selected. Before surgery, a radiographic evaluation was performed with a supine and a Fisk radiograph. Most supine radiographs (>75%) were non-interpretable and were excluded from the study. As some Fisk radiographs (26.7%) were also non-interpretable, that left 44 interpretable radiographs in the study. These were measured for medial opening angle, total opening angle, width and depth of the bicipital groove. The radiographic measurements and the presence of LHBT pathology, as assessed at arthroscopy, were correlated. RESULTS Radiographic evaluation of the bicipital groove showed a mean medial opening angle of 53±15o (23 - 90), a mean total opening angle of 80±26o (30 - 135), a mean width of 10.3±2.5mm (6 - 19) and a mean depth of 4.1±1.5mm (1 - 8). Men had higher medial opening angle (60 vs 50o, p=0.044) and wider grooves (11.9 vs 9.7mm, p=0.019). Twenty-five patients (56.8%) were found to have an abnormal LHBT. No correlation was found between the radiographic measurements and LHBT pathology. Only age was correlated with a LHBT lesion (61.8 vs 46.3 years, p <0.001). CONCLUSIONS Our results show that there is no correlation between radiographic morphologic evaluation of the bicipital groove and LHBT pathology.
Collapse
Affiliation(s)
- A Cardoso
- Hospital Beatriz Angelo, Loures, Portugal.
| | | | - R Viegas
- Hospital Beatriz Angelo, Loures, Portugal
| | - P Amaro
- Hospital Beatriz Angelo, Loures, Portugal
| | - P Gamelas
- Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
| | - R Alonso
- Hospital Beatriz Angelo, Loures, Portugal
| | - L Pires
- Hospital Beatriz Angelo, Loures, Portugal
| |
Collapse
|
21
|
Capdevila-Reniu A, Navarro-López M, López-Soto A. Osteoporotic vertebral fractures: A diagnostic challenge in the 21 st century. Rev Clin Esp 2020; 221:118-124. [PMID: 33998487 DOI: 10.1016/j.rceng.2019.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 09/05/2019] [Indexed: 10/24/2022]
Abstract
Vertebral fractures are the most prevalent osteoporotic fractures and are paradoxically the most underdiagnosed. While only one-third of patients have acute pain, they can present other associated chronic complications. Vertrebal fractures are associated with the onset of new fractures, both vertebral and nonvertebral. Radiography of the dorsal-lumbar spine is a useful tool for detecting them but depends on the subjective interpretation of the physician conducting the assessment. New techniques, such as vertebral morphometry, have recently demonstrated greater efficacy in detecting v vertebral fractures and are performed concomitantly with bone densitometry. Knowing how to identify vertebral fractures is essential for the secondary prevention of new fractures and improving our patients' quality of life.
Collapse
Affiliation(s)
- A Capdevila-Reniu
- Servicio de Medicina Interna, Unidad de Geriatria, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - M Navarro-López
- Servicio de Medicina Interna, Unidad de Geriatria, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - A López-Soto
- Servicio de Medicina Interna, Unidad de Geriatria, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
22
|
Crespo Villalba FJ. Dr. Hyacinthe Guilleminot and the first respiratory and cardiac synchronisation systems for obtaining radiological images. Radiologia (Engl Ed) 2018; 61:239-246. [PMID: 30293916 DOI: 10.1016/j.rx.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 08/07/2018] [Accepted: 08/20/2018] [Indexed: 11/18/2022]
Abstract
In an era when it was not possible to achieve quality x-rays with short exposure times, the need to obtain chest images without movement led the French doctor Emré Hyacinthe Guilleminot to construct a machine that repeatedly emitted x-rays only when desired during the respiratory cycle. His aim was to create a satisfactory radiograph from multiple short bursts performed at the moment of inhalation or exhalation, based on Charles Bouchard's research on heart disease. He extended his idea to radiography of the heart, creating a system that enabled images to be obtained disassociating the phases of heartbeat. This article seeks to explain the basic functioning of these mechanisms, and to recover previous research papers that led to their creation. We will also retrieve biographical and personal data of the two people involved - one directly, the other indirectly - in these novel inventions.
Collapse
|
23
|
Garrido P, Sánchez M, Belda Sanchis J, Moreno Mata N, Artal Á, Gayete Á, Matilla González JM, Galbis Caravajal JM, Isla D, Paz-Ares L, Seijo LM. Reflections on the Implementation of Low-Dose Computed Tomography Screening in Individuals at High Risk of Lung Cancer in Spain. Arch Bronconeumol 2017; 53:568-573. [PMID: 28416207 DOI: 10.1016/j.arbres.2017.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/07/2017] [Accepted: 03/08/2017] [Indexed: 12/17/2022]
Abstract
Lung cancer (LC) is a major public health issue. Despite recent advances in treatment, primary prevention and early diagnosis are key to reducing the incidence and mortality of this disease. A recent clinical trial demonstrated the efficacy of selective screening by low-dose computed tomography (LDCT) in reducing the risk of both lung cancer mortality and all-cause mortality in high-risk individuals. This article contains the reflections of an expert group on the use of LDCT for early diagnosis of LC in high-risk individuals, and how to evaluate its implementation in Spain. The expert group was set up by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), the Spanish Society of Thoracic Surgery (SECT), the Spanish Society of Radiology (SERAM) and the Spanish Society of Medical Oncology (SEOM).
Collapse
Affiliation(s)
- Pilar Garrido
- Servicio de Oncología Médica, Hospital Ramón y Cajal, Madrid, España.
| | - Marcelo Sánchez
- Servicio de Radiodiagnóstico, Hospital Clínic, Barcelona, España
| | - José Belda Sanchis
- Servicio Mancomunado de Cirugía Torácica, Hospitales Universitari Mútua Terrassa, Sant Pau i Santa Creu y Mar, Barcelona, España
| | - Nicolás Moreno Mata
- Servicio de Cirugía Torácica, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Ángel Artal
- Servicio de Oncología Médica, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Ángel Gayete
- Servicio de Radiodiagnóstico, Hospital del Mar, Barcelona, España
| | | | | | - Dolores Isla
- Servicio de Oncología Médica, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - Luis Paz-Ares
- Servicio de Oncología Médica, Hospital Universitario 12 de Octubre, Madrid, España
| | - Luis M Seijo
- Servicio de Neumología, Hospital Universitario Fundación Jiménez Díaz, Instituto de Investigación Sanitaria, CIBERES, Madrid, España
| |
Collapse
|
24
|
Izquierdo YE, Calvo Páramo E, Castañeda LM, Gómez SV, Zambrano FS. Radiographic changes of the distal phalangeal tuft of the hands in subjects with systemic sclerosis. Systematic review. ACTA ACUST UNITED AC 2016; 14:20-26. [PMID: 27746086 DOI: 10.1016/j.reuma.2016.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/13/2016] [Accepted: 08/18/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine abnormal plain radiograph findings of the distal phalanx tuft of the hand (DPTH) associated with systemic sclerosis in adults. METHODS A systematic review was developed following the parameters of the PRISMA guidelines in databases: MEDLINE, EMBASE, BIREME, Scielo, Google Scholar and others including as primary outcomes alterations of DPTH (erosions, resorption, sclerosis and proliferation) detected by simple radiography in subjects with systemic sclerosis. The prevalence of radiographic findings was synthesized using the fixed effects model. The statistical associations were expressed in terms of relative risk or odds ratio with their respective confidence intervals and p values. RESULTS Twenty-two observational studies were included; the prevalence of DPTH resorption was 28.3% (95% CI: 0.256-0.312; p < .001); I2=80.4%, the prevalence of calcinosis was 15.6% (95% CI: 0.113-0.210; p < .001); I2=0%. No study reported proliferation or erosions and only one study described sclerosis of DPTH in 5 individuals. CONCLUSIONS Resorption and calcinosis of DPTH are the characteristic radiographic findings in patients with systemic sclerosis. However, new studies with greater methodological strength are needed to establish associations between these phenomena and their presence in other connective tissue diseases.
Collapse
Affiliation(s)
- Yojhan Edilberto Izquierdo
- Departamento de imágenes diagnósticas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá D.C., Colombia; Grupo de Investigación en Radiología e Imágenes Diagnósticas (GRID), Bogotá D.C., Colombia.
| | - Enrique Calvo Páramo
- Departamento de imágenes diagnósticas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá D.C., Colombia; Grupo de Investigación en Radiología e Imágenes Diagnósticas (GRID), Bogotá D.C., Colombia
| | - Luisa María Castañeda
- Departamento de imágenes diagnósticas, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá D.C., Colombia; Grupo de Investigación en Radiología e Imágenes Diagnósticas (GRID), Bogotá D.C., Colombia
| | - Sandra Viviana Gómez
- Grupo de Investigación en Radiología e Imágenes Diagnósticas (GRID), Bogotá D.C., Colombia
| | | |
Collapse
|
25
|
Velasco R, Arribas M, Valencia C, Zamora N, Fernández SM, Lobeiras A, Urbaneja E, Garrote R, González L, Benito H. [Compliance with the PECARN and AEP guidelines in diagnostic approach of mild head trauma in patients younger than 24 months old]. An Pediatr (Barc) 2014; 83:166-72. [PMID: 25547667 DOI: 10.1016/j.anpedi.2014.10.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/13/2014] [Accepted: 10/20/2014] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Mild head trauma is a frequent complaint in Pediatric Emergency Departments. Several guidelines have been published in the last few years. However, significant variability can be appreciated in terms of the demand for image tests. The aim of this study is to determine the level of compliance with PECARN and AEP guidelines in the management of patients younger than 24 months old in four different hospitals. PATIENTS AND METHODS A multicenter retrospective study was conducted on patients presenting with mild head trauma between October 1st, 2011 and March 31st, 2013 in the Emergency Departments of four hospitals. RESULTS In the analysis of the results obtained, only one of the four hospitals complied with the AEP guidelines in more than 50% of the patients. The other three hospitals had a level of compliance lower than 50%. Management was more suitable according to PECARN guidelines, with 3 of the 4 hospitals having a level of compliance greater than 50%. However, the best compliance achieved by a hospital was only of 70%. CONCLUSIONS The study shows that the level of compliance with guidelines for management of mild head trauma in patients younger than 24 months old is low.
Collapse
Affiliation(s)
- R Velasco
- Unidad de Urgencias Pediátricas, Servicio de Pediatría, Hospital Universitario Río Hortega, Valladolid, España.
| | - M Arribas
- Unidad de Urgencias Pediátricas, Servicio de Pediatría, Hospital Universitario Río Hortega, Valladolid, España
| | - C Valencia
- Unidad de Urgencias Pediátricas, Servicio de Pediatría, Hospital Universitario Río Hortega, Valladolid, España
| | - N Zamora
- Unidad de Urgencias Pediátricas, Servicio de Pediatría, Hospital Universitario Río Hortega, Valladolid, España
| | - S M Fernández
- Servicio de Urgencias Pediátricas, Hospital Universitario Cruces, Barakaldo, Bizkaia, España
| | - A Lobeiras
- Servicio de Urgencias Pediátricas, Hospital Universitario Cruces, Barakaldo, Bizkaia, España
| | - E Urbaneja
- Servicio de Pediatría, Hospital Clínico Universitario, Valladolid, España
| | - R Garrote
- Servicio de Pediatría, Hospital Clínico Universitario, Valladolid, España
| | - L González
- Servicio de Pediatría, Hospital Nuestra Señora de Sonsoles, Ávila, España
| | - H Benito
- Servicio de Pediatría, Hospital Nuestra Señora de Sonsoles, Ávila, España
| |
Collapse
|
26
|
Alonso Quintela P, Oulego Erroz I, Mora Matilla M, Rodríguez Blanco S, Mata Zubillaga D, Regueras Santos L. [Usefulness of bedside ultrasound compared to capnography and X-ray for tracheal intubation]. An Pediatr (Barc) 2014; 81:283-8. [PMID: 24560730 DOI: 10.1016/j.anpedi.2014.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 01/07/2014] [Accepted: 01/10/2014] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the usefulness of bedside ultrasound compared to capnography and X-ray for endotracheal intubation in children and newborns. MATERIALS AND METHODS Hemodynamically stable children intubated in pedriatric and neonatal intensive care unit were included. Endotracheal tube insertion was checked after every intubation attempt by tracheal ultrasound and capnography simultaneously. The endotracheal tube insertion depth was then checked by assesment of lung sliding by thoracic ultrasound. Thereafter, Chest X-ray was performed and interpreted as usual. Time to perform each technique was recorded. RESULTS The study included 31 intubations in 26 patients (15 in PICU and 16 in NICU). There were no statistically significant differences between tracheal ultrasound and capnography or between thoracic ultrasound and x-ray in identifying the correct endotracheal intubation and assessment of endotracheal tube insertion depth, respectively. Sensibility and specificity of ultrasound compared to capnography was 92% and 100%, and 100% and 75% compared to X-ray. Ultrasound was significantly slower compared to capnography [12 (4-16) vs 6 (3-12) seconds; P<.001] and significantly quicker compared to X-ray [0.22 (0.17-0.40) vs. 20 (17-25) minutes, P<.001]. CONCLUSIONS Ultrasound appears to be as effective as capnography, although slower, for identifying endotracheal intubation. Ultrasound may be useful in clinical situations, such as cardiopulmonary resuscitation where capnography is less reliable. Ultrasound is as effective and quicker than X-ray for assessment of endotracheal tube insertion depth, and it may contribute to decrease the routine use of X-ray after tracheal intubation.
Collapse
Affiliation(s)
- P Alonso Quintela
- Servicio Pediatría, Complejo Asistencial Universitario de León, León, España.
| | - I Oulego Erroz
- Servicio de Cardiología, Complejo Asistencial Universitario de León, León, España; Unidad de Cuidados Intensivos Pediátricos, Complejo Asistencial Universitario de León, León, España
| | - M Mora Matilla
- Servicio Pediatría, Complejo Asistencial Universitario de León, León, España
| | - S Rodríguez Blanco
- Servicio de Neonatología, Complejo Asistencial Universitario de León, León, España; Unidad de Cuidados Intensivos Pediátricos, Complejo Asistencial Universitario de León, León, España
| | - D Mata Zubillaga
- Centro de Salud Ponferrada IV, Complejo Asistencial Universitario de León, León, España
| | - L Regueras Santos
- Unidad de Cuidados Intensivos Pediátricos, Complejo Asistencial Universitario de León, León, España
| |
Collapse
|
27
|
Morán Blanco LM, Encinas Rodríguez C. [Multiple myeloma with diffuse osteosclerosis: distinct from POEMS syndrome]. Radiologia 2013; 56:e29-33. [PMID: 23890791 DOI: 10.1016/j.rx.2013.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 04/20/2013] [Accepted: 04/23/2013] [Indexed: 10/26/2022]
Abstract
Diffuse osteosclerotic lesions are a very uncommon radiologic presentation in multiple myeloma. These lesions affect the axial skeleton and proximal limbs; they may be accompanied by osteolytic lesions in the course of the disease. In fact, in cases of diffuse osteosclerosis, the diagnosis of multiple myeloma is reached only after ruling out other, more common diseases. We present an exceptional case of multiple myeloma with diffuse osteosclerosis and highlight the differences between this entity and POEMS syndrome.
Collapse
Affiliation(s)
- L M Morán Blanco
- Servicio de Radiología, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - C Encinas Rodríguez
- Servicio de Hematología, Hospital General Universitario Gregorio Marañón, Madrid, España
| |
Collapse
|
28
|
Arias Fernández J, Broncano Cabrero J, Bondía Gracia JM, Aquerreta Beola JD. [Radiological manifestations of Baastrup's disease in children]. Radiologia 2011; 55:447-50. [PMID: 21958726 DOI: 10.1016/j.rx.2011.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 01/11/2011] [Accepted: 01/12/2011] [Indexed: 11/16/2022]
Abstract
Baastrup's disease is not usually considered among the possible causes of low back pain in children. Classically, Baastrup's disease is characterized by degenerative phenomena secondary to friction between adjacent spinous processes, with sclerosis of the margins and decrease in the interspinous space. Baastrup's disease becomes more prevalent with age and is usually accompanied by degenerative changes in the vertebral column, such as lumbar facet hypertrophy or disc disease. Certain activities like dance or gymnastics can make Baastrup's disease more likely to appear at an earlier age. In children, Baastrup's disease can manifest in a different way, with increased interspinous spaces and bone remodeling. In this article, we present the cases of two patients with low back pain who were diagnosed with Baastrup's disease.
Collapse
Affiliation(s)
- J Arias Fernández
- Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, España.
| | | | | | | |
Collapse
|