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Vancappel A, Jansen E, Bachem R, Bray A, Egreteau L, Réveillère C, Maercker A, El-Hage W. Validation of the French ADNM-20 in the assessment of emotional difficulties resulting from COVID-19 quarantine and outbreak. BMC Psychol 2021; 9:180. [PMID: 34774108 PMCID: PMC8590117 DOI: 10.1186/s40359-021-00683-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/31/2021] [Accepted: 11/01/2021] [Indexed: 12/04/2022] Open
Abstract
Background Multiple psychological consequences of the COVID-19 outbreak and quarantine have been described. However, there is a lack of global conceptualization. We argue that the stressful aspects of the situation, the multiple environmental consequences of the outbreak, and the diversity of symptoms observed in such a situation, suggest that Adjustment disorder (AD) is a promising way to conceptualize the psychological consequences of the outbreak and quarantine. The first aim of the study was to validate the French version of the ADNM. The second aim was to set out adjustment difficulties resulting from COVID-19 outbreak and quarantine. Method We recruited 1010 (840 women, 170 men) who consented online to participate. They filled out the French ADNM, visual analogic scales, HADS, IES, and the COPE, to evaluate coping strategies. Results We confirmed the factor structure of the ADNM and we found good psychometric properties. We found that 61.3% of participants presented an adjustment disorder related to COVID-19 outbreak. We found multiple risk factors and protective factors to AD due to quarantine and outbreak. We also identified the coping strategies negatively and positively associated with AD. Conclusion Adjustment disorder is a relevant concept to understand psychological manifestations caused by quarantine and outbreak. The French ANDM has good psychometric properties to evaluate such manifestations. The association between coping strategies and AD symptoms suggest that CBT may be the best intervention to help people suffering from AD. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00683-7.
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Affiliation(s)
- A Vancappel
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France. .,Département de Psychologie, EE 1901 Qualipsy, Qualité de vie et Santé Psychologique, Université de Tours, Tours, France. .,UMR 1253, iBrain, Inserm, Université de Tours, Tours, France.
| | - E Jansen
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France
| | - R Bachem
- Universität Zürich, Zurich, Switzerland
| | - A Bray
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France
| | - L Egreteau
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France
| | - C Réveillère
- Département de Psychologie, EE 1901 Qualipsy, Qualité de vie et Santé Psychologique, Université de Tours, Tours, France
| | | | - W El-Hage
- Pôle de Psychiatrie-Addictologie, Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France.,UMR 1253, iBrain, Inserm, Université de Tours, Tours, France
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Sangal RB, Bray A, Reid E, Ulrich A, Liebhardt B, Venkatesh AK, King M. Leadership communication, stress, and burnout among frontline emergency department staff amid the COVID-19 pandemic: A mixed methods approach. Healthc (Amst) 2021; 9:100577. [PMID: 34411923 PMCID: PMC8361146 DOI: 10.1016/j.hjdsi.2021.100577] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/13/2021] [Accepted: 07/05/2021] [Indexed: 11/27/2022]
Abstract
Background Organizations have a key role to play in supporting healthcare workers (HCWs) and mitigating stress during COVID-19. We aimed to understand whether perceptions of support and communication by local leadership were associated with reduced reports of stress and burnout among frontline HCWs. Methods We conducted cross-sectional surveys embedded within emergency department (ED) workflow during the first wave of COVID-19 from April 9, 2020 to June 15th, 2020 within three EDs of a multisite health system in the Northeast United States. All ED HCWs were administered electronic surveys during shift via text message. We simultaneously conducted 64 qualitative interviews to better characterize and validate survey responses. Primary survey outcomes were levels of work stress and burnout. Results Over 10 week study, 327 of 431 (76%) frontline HCWs responded to at least one round of the survey. More useful communication mediated through higher perception of support was significantly associated with lower work stress (B = −0.33, p < 0.001) and burnout (B = −7.84, p < 0.001). A one-point increase on the communication Likert scale was associated with a 9% reduction in stress and a 19% reduction in burnout. Three themes related to effective crisis communication during COVID-19 emerged in interviews: (1) information consolidation prior to dissemination, (2) consistency of communication, and (3) bi-directional communication. Conclusion This work suggests that effective local leadership communication, characterized by information consolidation, consistency, and bi-directionality, leads to higher perceptions of support and lower stress and burnout among ED frontline workers. As the pandemic continues, these results present an evidence-based framework for leaders to support frontline HCWs through effective crisis communication.
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Affiliation(s)
- Rohit B Sangal
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA.
| | - Alexandra Bray
- Yale University School of Management, New Haven, CT, USA
| | - Eleanor Reid
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Andrew Ulrich
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | | | - Arjun K Venkatesh
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale University, New Haven, CT, USA
| | - Marissa King
- Yale University School of Management, New Haven, CT, USA
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Brady JM, Bray A, Kim P, Schneider B, Lippe J, Mercer D, Sutton K. Female Residents Give Themselves Lower Scores Than Male Colleagues and Faculty Evaluators on ACGME Milestones. J Surg Educ 2021; 78:1305-1311. [PMID: 33349566 DOI: 10.1016/j.jsurg.2020.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/20/2020] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Orthopedic surgery is one of the specialties with the lowest number of women residents and practicing surgeons. The gender discrepancy in orthopedic residency training may drive a competency bias. We asked whether female orthopedic surgery residents score themselves lower on the Accreditation Council for Graduate Medical Education (ACGME) Milestones than their male counterparts, and lower than their faculty evaluators. DESIGN We conducted a retrospective review of ACGME Milestone data from faculty and residents over a 4-year period. The data were analyzed using a snapshot of PGY2 (n = 20 residents) and PGY4 (n = 19 residents) scores, and using a Generalized Estimation Equation (GEE) to account for additional data points from the same residents over the 4-year data collection period. SETTING Assessment scores were compiled from a single orthopedic surgery residency at Oregon Health & Science University from 2014 to 2017. PARTICIPANTS The residency program has 5 residents in each program year (PGY1 through PGY5); a total of 25 residents during each year of the study were included. RESULTS On average, female residents scored themselves lower than both their male counterparts and their faculty mentors. Female PGY2 self-evaluation scores were lower than males in both patient care (p = 0.005) and medical knowledge (p < 0.001). When the GEE model was applied to 99 responses from 41 residents over a 4-year period, there were no gender-related differences in resident self-evaluation scores and in faculty scores of male and female residents, with the exception of meniscal tear. For this milestone, faculty rated female residents lower than males. Furthermore, the differences between faculty evaluation scores and resident self-evaluation scores were significantly lower for males than for females for 4 of the clinical domains, as well as the systems-based practice domains of cost and communication. CONCLUSIONS Our results indicate female residents are at risk for a competency bias during training, as reflected by evaluations using the ACGME Milestones.
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Affiliation(s)
- Jacqueline M Brady
- Department of Orthopaedics and Rehabilitation, School of Medicine, Oregon Health & Sciences University School of Medicine, Portland, Oregon.
| | - Alexandra Bray
- University of California, Irvine, School of Medicine, Irvine, California
| | - Peter Kim
- Department of Orthopaedics and Rehabilitation, Physical Medicine & Rehabilitation, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Brandon Schneider
- Department of Orthopaedics and Rehabilitation, Hospital for Special Surgery, New York, New York
| | | | - Deana Mercer
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Karen Sutton
- Hospital for Special Surgery, Outpatient Center, Stamford, Connecticut
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Sangal RB, Wrzesniewski A, DiBenigno J, Reid E, Ulrich A, Liebhardt B, Bray A, Yang E, Eun E, Venkatesh AK, King M. Work team identification associated with less stress and burnout among front-line emergency department staff amid the COVID-19 pandemic. leader 2020. [DOI: 10.1136/leader-2020-000331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BackgroundThe COVID-19 pandemic has exposed front-line healthcare workers to unprecedented risks and stressors threatening both physical and mental health. Prior work in the military has found that team identification, or the sense that one was a part of a team, can help reduce stress and prevent burnout during prolonged stress.MethodsWe conducted repeated cross-sectional surveys embedded within emergency department workflow to understand whether team identification was associated with reduced reports of stress and burnout among front-line workers.ResultsDuring the 10-week study which spanned the first wave of COVID-19, 327 of 431 (76%) front-line healthcare workers responded to at least one round of the survey. Higher team identification was associated with significantly less work stress (B=−0.60, 95% CI −0.84 to to -0.40, p<0.001) and burnout (B=−12.87, 95% CI −17.73 to -8.02, p<0.001) in cross-sectional analyses. Further evidence of the protective effect of team identification for work stress (B=−0.36, 95% CI −0.76 to 0.05, p=0.09) and burnout (B=−13.25, 95% CI −17.77 to -8.73, p<0.001) was also found in prospective longitudinal evidence.ConclusionThis work suggests work team identification is a key buffering factor against feelings of stress and burnout. Efforts to promote team identification may offer a promising way for leaders to support front-line healthcare workers’ well-being during the COVID-19 pandemic. These results can inform ongoing COVID-19 operational and quality improvement initiatives.
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Brunault P, Bray A, Rerolle C, Cognet S, Gaillard P, El-Hage W. Différences d’accès à Internet et de recherche d’informations en santé via Internet selon le trouble psychiatrique. Rev Epidemiol Sante Publique 2017; 65:125-136. [DOI: 10.1016/j.respe.2016.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 04/22/2016] [Accepted: 11/23/2016] [Indexed: 10/20/2022] Open
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Tian T, Myers L, Bray A, Bogucki P, de Berker D. 013 WHO surgical checklist in dermatology: compliance, attitudes, & barriers. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bray A. Asthma in the Workplace. Occup Med (Lond) 2014. [DOI: 10.1093/occmed/kqt137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Li KKW, Pang JCS, Ng HK, Massimino M, Gandola L, Biassoni V, Spreafico F, Schiavello E, Poggi G, Casanova M, Pecori E, De Pava MV, Ferrari A, Meazza C, Terenziani M, Polastri D, Luksch R, Podda M, Modena P, Antonelli M, Giangaspero F, Ahmed S, Zaghloul MS, Mousa AG, Eldebawy E, Elbeltagy M, Awaad M, Massimino M, Gandola L, Biassoni V, Antonelli M, Schiavello E, Buttarelli F, Spreafico F, Collini P, Pollo B, Patriarca C, Giangaspero F, MacDonald T, Liu J, Munson J, Park J, Wang K, Fei B, Bellamkonda R, Arbiser J, Gomi A, Yamaguchi T, Mashiko T, Oguro K, Somasundaram A, Neuberg R, Grant G, Fuchs H, Driscoll T, Becher O, McLendon R, Cummings T, Gururangan S, Bourdeaut F, Grison C, Doz F, Pierron G, Delattre O, Couturier J, Cho YJ, Pugh T, Weeraratne SD, Archer T, Krummel DP, Auclair D, Cibulkis K, Lawrence M, Greulich H, McKenna A, Ramos A, Shefler E, Sivachenko A, Amani V, Pierre-Francois J, Teider N, Northcott P, Taylor M, Meyerson M, Pomeroy S, Potts C, Cline H, Rotenberry R, Guldal C, Bhatia B, Nahle Z, Kenney A, Fan YN, Pizer B, See V, Makino K, Nakamura H, Kuratsu JI, Grahlert J, Ma M, Fiaschetti G, Shalaby T, Grotzer M, Baumgartner M, Clifford S, Gustafsson G, Ellison D, Figarella-Branger D, Doz F, Rutkowski S, Lannering B, Pietsch T, Fiaschetti G, Shalaby T, Baumgartner M, Grotzer M, Fleischhack G, Siegler N, Zimmermann M, Rutkowski S, Warmuth-Metz M, Kortmann RD, Pietsch T, Faldum A, Bode U, Yoon JH, Kang HJ, Park KD, Park SH, Phi JH, Kim SK, Wang KC, Kim IH, Shin HY, Ahn HS, Faria C, Golbourn B, Smith C, Rutka J, Greene BD, Whitton A, Singh S, Scheinemann K, Hill R, Lindsey J, Howell C, Ryan S, Shiels K, Shrimpton E, Bailey S, Clifford S, Schwalbe E, Lindsey J, Williamson D, Hamilton D, Northcott P, O'Toole K, Nicholson SL, Lusher M, Gilbertson R, Hauser P, Taylor M, Taylor R, Ellison D, Bailey S, Clifford S, Kool M, Jones DTW, Jager N, Hovestadt V, Schuller U, Jabado N, Perry A, Cowdrey C, Croul S, Collins VP, Cho YJ, Pomeroy S, Eils R, Korshunov A, Lichter P, Pfister S, Northcott P, Shih D, Taylor M, Darabi A, Sanden E, Visse E, Siesjo P, Harris P, Venkataraman S, Alimova I, Birks D, Cristiano B, Donson A, Foreman N, Vibhakar R, Bertin D, Vallero S, Basso ME, Romano E, Peretta P, Morra I, Mussano A, Fagioli F, Kunkele A, De Preter K, Heukamp L, Thor T, Pajtler K, Hartmann W, Mittelbronn M, Grotzer M, Deubzer H, Speleman F, Schramm A, Eggert A, Schulte J, Bandopadhayay P, Kieran M, Manley P, Robison N, Chi S, Thor T, Mestdagh P, Vandesomple J, Fuchs H, Durner VG, de Angelis MH, Heukamp L, Kunkele A, Pajtler K, Eggert A, Schramm A, Schulte JH, Ohe N, Yano H, Nakayama N, Iwama T, Lastowska M, Perek-Polnik M, Grajkowska W, Malczyk K, Cukrowska B, Dembowska-Baginska B, Perek D, Othman RT, Storer L, Grundy R, Kerr I, Coyle B, Hulleman E, Lagerweij T, Biesmans D, Crommentuijn MHW, Cloos J, Tannous BA, Vandertop WP, Noske DP, Kaspers GJL, Wurdinger T, Bergthold G, El Kababri M, Varlet P, Dhermain F, Sainte-Rose C, Raquin MA, Valteau-Couanet D, Grill J, Dufour C, Burchill C, Hii H, Dallas P, Cole C, Endersby R, Gottardo N, Gevorgian A, Morozova E, Kazantsev I, Youhta T, Safonova S, Kozlov A, Punanov Y, Afanasyev B, Zheludkova O, Packer R, Gajjar A, Michalski J, Jakacki R, Gottardo N, Tarbell N, Vezina G, Olson J, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Malbari F, Atlas M, Friedman G, Kelly V, Bray A, Cassady K, Markert J, Gillespie Y, Taylor R, Howman A, Brogden E, Robinson K, Jones D, Gibson M, Bujkiewicz S, Mitra D, Saran F, Michalski A, Pizer B, Jones DTW, Jager N, Kool M, Zichner T, Hutter B, Sultan M, Cho YJ, Pugh TJ, Warnatz HJ, Reifenberger G, Northcott PA, Taylor MD, Meyerson M, Pomeroy SL, Yaspo ML, Korbel JO, Korshunov A, Eils R, Pfister SM, Lichter P, Pajtler KW, Weingarten C, Thor T, Kuenkele A, Fleischhack G, Heukamp LC, Buettner R, Kirfel J, Eggert A, Schramm A, Schulte JH, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Kwiecien R, Pietsch T, Warmuth-Metz M, Faldum A, Kuehl J, Kortmann RD, Rutkowski S, Lupo P, Scheurer M, Martin A, Nirschl C, Polanczyk M, Cohen KJ, Pardoll DM, Drake CG, Lim M, Manoranjan B, Hallett R, Wang X, Venugopal C, McFarlane N, Sheinemann K, Hassell J, Singh S, Venugopal C, Manoranjan B, McFarlane N, Whitton A, Delaney K, Scheinemann K, Singh S, Manoranjan B, Hallett R, Venugopal C, McFarlane N, Hassell J, Scheinemann K, Dunn S, Singh S, Garcia I, Crowther AJ, Gama V, Miller CR, Deshmukh M, Gershon TR, Garcia I, Crowther AJ, Gershon TR, Gerber NU, von Hoff K, Friedrich C, von Bueren AO, Treulieb W, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Rutkowski S, Kortmann RD, Zin A, De Bortoli M, Bonvini P, Viscardi E, Perilongo G, Rosolen A, Connolly E, Zhang C, Anderson R, Feldstein N, Stark E, Garvin J, Shing MMK, Lee V, Cheng FWT, Leung AWK, Zhu XL, Wong HT, Kam M, Li CK, Ward S, Sengupta R, Kroll K, Rubin J, Dallas P, Milech N, Longville B, Hopkins R, Vergiliana JVD, Endersby R, Gottardo N, von Bueren AO, Gerss J, Hagel C, Cai H, Remke M, Hasselblatt M, Feuerstein BG, Pernet S, Delattre O, Korshunov A, Rutkowski S, Pfister SM, Baudis M, Lee C, Fotovati A, Triscott J, Dunn S, Valdora F, Freier F, Seyler C, Brady N, Bender S, Northcott P, Kool M, Jones D, Coco S, Tonini GP, Scheurlen W, Boutros M, Taylor M, Katus H, Kulozik A, Zitron E, Korshunov A, Lichter P, Pfister S, Remke M, Shih DJH, Northcott PA, Van Meter T, Pollack IF, Van Meir E, Eberhart CG, Fan X, Dellatre O, Collins VP, Jones DTW, Clifford SC, Pfister SM, Taylor MD, Pompe R, von Bueren AO, von Hoff K, Friedrich C, Treulieb W, Lindow C, Deinlein F, Kuehl J, Rutkowski S, Gupta T, Krishnatry R, Shirsat N, Epari S, Kunder R, Kurkure P, Vora T, Moiyadi A, Jalali R, Cohen K, Perek D, Perek-Polnik M, Dembowska-Baginska B, Drogosiewicz M, Grajkowska W, Lastowska M, Chojnacka M, Filipek I, Tarasinska M, Roszkowski M, Hauser P, Jakab Z, Bognar L, Markia B, Gyorsok Z, Ottoffy G, Nagy K, Cservenyak J, Masat P, Turanyi E, Vizkeleti J, Krivan G, Kallay K, Schuler D, Garami M, Lacroix J, Schlund F, Adolph K, Leuchs B, Bender S, Hielscher T, Pfister S, Witt O, Schlehofer JR, Rommelaere J, Witt H, Leskov K, Ma N, Eberhart C, Stearns D, Dagri JN, Torkildson J, Evans A, Ashby LS, Zakotnik B, Brown RJ, Dhall G, Portnow J, Finlay JL, McCabe M, Pizer B, Marino AM, Baryawno N, Ekstrom TP, Ostman A, Johnsen JI, Robinson G, Parker M, Kranenburg T, Lu C, Pheonix T, Huether R, Easton J, Onar A, Lau C, Bouffet E, Gururangan S, Hassall T, Cohn R, Gajjar A, Ellison D, Mardis E, Wilson R, Downing J, Zhang J, Gilbertson R, Robinson G, Dalton J, O'Neill T, Yong W, Chingtagumpala M, Bouffet E, Bowers D, Kellie S, Gururangan S, Fisher P, Bendel A, Fisher M, Hassall T, Wetmore C, Broniscer A, Clifford S, Gilbertson R, Gajjar A, Ellison D, Zhukova N, Martin D, Lipman T, Castelo-Branco P, Zhang C, Fraser M, Baskin B, Ray P, Bouffet E, Alman B, Ramaswamy V, Dirks P, Clifford S, Rutkowski S, Pfister S, Bristow R, Taylor M, Malkin D, Hawkins C, Tabori U, Dhall G, Ji L, Haley K, Gardner S, Sposto R, Finlay J, Leary S, Strand A, Ditzler S, Heinicke G, Conrad L, Richards A, Pedro K, Knoblaugh S, Cole B, Olson J, Yankelevich M, Budarin M, Konski A, Mentkevich G, Stefanits H, Ebetsberger-Dachs G, Weis S, Haberler C, Milosevic J, Baryawno N, Sveinbjornsson B, Martinsson T, Grotzer M, Johnsen JI, Kogner P, Garzia L, Morrisy S, Jelveh S, Lindsay P, Hill R, Taylor M, Marks A, Zhang H, Rood B, Williamson D, Clifford S, Aurtenetxe O, Gaffar A, Lopez JI, Urberuaga A, Navajas A, O'Halloran K, Hukin J, Singhal A, Dunham C, Goddard K, Rassekh SR, Davidson TB, Fangusaro JR, Ji L, Sposto R, Gardner SL, Allen JC, Dunkel IJ, Dhall G, Finlay JL, Trivedi M, Tyagi A, Goodden J, Chumas P, O'kane R, Crimmins D, Elliott M, Picton S, Silva DS, Viana-Pereira M, Stavale JN, Malheiro S, Almeida GC, Clara C, Jones C, Reis RM, Spence T, Sin-Chan P, Picard D, Ho KC, Lu M, Huang A, Bochare S, Khatua S, Gopalakrishnan V, Chan TSY, Picard D, Pfister S, Hawkins C, Huang A, Chan TSY, Picard D, Ho KC, Huang A, Picard D, Millar S, Hawkins C, Rogers H, Kim SK, Ra YS, Fangusaro J, Toledano H, Nakamura H, Van Meter T, Pomeroy S, Ng HK, Jones C, Gajjar A, Clifford S, Pfister S, Eberhart C, Bouffet E, Grundy R, Huang A, Sengupta S, Weeraratne SD, Phallen J, Sun H, Rallapalli S, Amani V, Pierre-Francois J, Teider N, Cook J, Jensen F, Lim M, Pomeroy S, Cho YJ. MEDULLOBLASTOMA. Neuro Oncol 2012; 14:i82-i105. [PMCID: PMC3483339 DOI: 10.1093/neuonc/nos093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
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Haggiag S, Mercurio A, Bray A, Valentini F, Gasperini C, Galgani S. Bone Mineral Density Assessment in a Multiple Sclerosis Population (P06.163). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hale L, Bray A, Littmann A. Assessing the balance capabilities of people with profound intellectual disabilities who have experienced a fall. J Intellect Disabil Res 2007; 51:260-8. [PMID: 17326807 DOI: 10.1111/j.1365-2788.2006.00873.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Although it is common for people with intellectual disability (ID) to fall, the reasons for this have not yet been identified. This pilot study aimed to explore the balance capabilities of a sample of adults with profound ID who had experienced a fall, in order to identify possible reasons for falling and to identify potential tests that could be used to quantify balance capabilities in this population group. METHODS The neuromuscular systems and balance capabilities of 20 adults with profound ID were comprehensively assessed with a battery of tests, including computerized posturography. RESULTS Of the 20 participants, 15 described themselves as frequent fallers, and 10 participants reported serious injuries as a result of falling. Formalized assessment of the neuromuscular and balance capabilities proved to be challenging, with many participants unable to comprehend what was required of them in the performance of a number of the tests. All participants were observed to have an abnormal pattern of walking. Nine participants completed posturography testing, the main finding of which was that low motor control composite scores indicated a slowing of motor responses to postural perturbations. Other potential risk factors identified were concurrent medical problems, medication, the context and environment of falling, movement impulsiveness and distractibility, and visual deficits. CONCLUSION The reason why people with ID frequently fall appears complex and multifactorial. Larger studies are required to verify the potential risk factors identified in this pilot study. Many of the standardized outcome measures commonly used in physiotherapy practice to quantify balance capabilities are not suitable for use in this population group, as participants found it difficult to comprehend what was required of them. Allowing the person to become familiarized with both the test and the tester may help to alleviate this problem. Videotaping and quantifying observations of strategies people use to perform common movements such as walking or turning maybe a more appropriate measurement tool of balance capabilities of people with ID than current standardized measures. This method would require rigorous development.
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Affiliation(s)
- L Hale
- School of Physiotherapy, University of Otago, Dunedin, New Zealand.
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Gresty MA, Waters S, Bray A, Bunday K, Golding JF. Impairment of spatial cognitive function with preservation of verbal performance during spatial disorientation. Curr Biol 2004; 13:R829-30. [PMID: 14588257 DOI: 10.1016/j.cub.2003.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ioannidis JPA, Trikalinos TA, Law M, Carr A, Carr A, Barr D, Cooper DA, Emery S, Grinspoon S, Ioannidis J, Lewis R, Law M, Lichtenstein K, Murray J, Pizzuti D, Powderly WG, Rozenbaum W, Schambelan M, Puls R, Emery S, Moore A, Miller J, Carr A, Belloso WH, Ivalo SA, Clara LO, Barcan LA, Stern LD, Galich AM, Perman MI, Losso M, Duran A, Toibaro J, Baker D, Vale R, McFarlane R, MacLeod H, Kidd J, Genn B, Carr A, Fielden R, Mallal S, French M, Cain A, Skett J, Maxwell D, Mijch A, Hoy J, Pierce A, McCormick C, De Graaf B, Falutz J, Vatistas J, Dion L, Montaner J, Harris M, Phillips P, Montessori V, Valyi M, Stewart W, Walmsley S, Casciaro L, Lundgren J, Andersen O, Gronholdt A, Beguinot I, Mercié P, Chêne G, Reynes J, Cotte L, Rozenbaum W, Nait-Ighil L, Slama L, Nguyen TH, Rousselle C, Viard JP, Roudière L, Maignan A, Burgard M, Mauss S, Schmutz G, Scholten S, Oka S, Fraser H, Ishihara M, Itoh K, Reiss P, van der Valk M, Leunissen P, Nievaard M, van EckSmit B, Kujik CC, Paton N, Peperstraete B, Karim F, Khim CY, Ong S, Gatell J, Martinez E, Milinkovic A, Churchill D, Timaeus C, Maher T, Perry N, Bray A, Moyle G, Baldwin C, Higgs C, Reynolds B, Carpenter C, Bausserman L, Fiore T, DiSpigno M, Cohen C, Hellinger J, Foy K, Hubka S, Riccio B, El-Sadr W, Raghavan S, Chowdury N, de Vries B, Miller S, Hammer S, Crawford M, Chang S, Dobkin J, Quagliarello B, Gallagher D, Punyanitya M, Kessler H, Tenorio A, Kjos S, Falloon J, Lane HC, Rock D, Ehler L, Lichtenstein K, McClain T, Murphy R, Milne P, Powderly W, Aberg J, Klebert M, Conklin M, Ward D, Green L, Stearn B. HIV Lipodystrophy Case Definition using Artificial Neural Network Modelling. Antivir Ther 2003. [DOI: 10.1177/135965350300800511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective A case definition of HIV lipodystrophy has recently been developed from a combination of clinical, metabolic and imaging/body composition variables using logistic regression methods. We aimed to evaluate whether artificial neural networks could improve the diagnostic accuracy. Methods The database of the case-control Lipodystrophy Case Definition Study was split into 504 subjects (265 with and 239 without lipodystrophy) used for training and 284 independent subjects (152 with and 132 without lipodystrophy) used for validation. Back-propagation neural networks with one or two middle layers were trained and validated. Results were compared against logistic regression models using the same information. Results Neural networks using clinical variables only (41 items) achieved consistently superior performance than logistic regression in terms of specificity, overall accuracy and area under the ROC curve. Their average sensitivity and specificity were 72.4 and 71.2%, as compared with 73.0 and 62.9% for logistic regression, respectively (area under the ROC curve, 0.784 vs 0.748). The discriminating performance of the neural networks was largely unaffected when built excluding 13 parameters that patients may not have readily available. The average sensitivity and specificity of the neural networks remained the same when metabolic variables were also considered (total 60 items) without a clear advantage against logistic regression (overall accuracy 71.8%). The performance of networks considering also body composition variables was similar to that of logistic regression (overall accuracy 78.5% for both). Conclusions Neural networks may offer a means to improve the discriminating performance for HIV lipodystrophy, when only clinical data are available and a rapid approximate diagnostic decision is needed. In this context, information on metabolic parameters is apparently not helpful in improving the diagnosis of HIV lipodystrophy, unless imaging and body composition studies are also obtained.
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Affiliation(s)
- John PA Ioannidis
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Division of Clinical Care Research, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Mass., USA
| | - Thomas A Trikalinos
- Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Division of Clinical Care Research, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Mass., USA
| | - Matthew Law
- National Centre in HIV Epidemiology and Clinical Research, Sydney, Australia
| | - Andrew Carr
- National Centre in HIV Epidemiology and Clinical Research, Sydney, Australia
- HIV, Immunology and Infectious Diseases Clinical Services Unit, St Vincent's Hospital, Australia
| | - A Carr
- (Forum for Collaborative HIV Research, Baltimore, Md., USA; to September, 2001)
| | - D Barr
- (Forum for Collaborative HIV Research, Baltimore, Md., USA; to September, 2001)
| | - DA Cooper
- (National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia)
| | - S Emery
- (Massachusetts General Hospital, Boston, Mass., USA)
| | - S Grinspoon
- (Massachusetts General Hospital, Boston, Mass., USA)
| | | | - R Lewis
- (Agouron Pharmaceuticals, San Diego, Calif., USA)
| | - M Law
- (HIV Outpatient Study/Centres for Diseases Control and Prevention, Denver, Col., USA)
| | - K Lichtenstein
- (HIV Outpatient Study/Centres for Diseases Control and Prevention, Denver, Col., USA)
| | - J Murray
- (US Department of Health and Human Services Food and Drug Administration, Washington, DC, USA)
| | - D Pizzuti
- (Bristol-Myers Squibb, Princeton, NJ, USA, representing the European Medicines Evaluation Agency Oversight Committee)
| | - WG Powderly
- (Agence Nationale du Researche sur le SIDA, Hôpital Rothschild, Paris, France)
| | - W Rozenbaum
- (Agence Nationale du Researche sur le SIDA, Hôpital Rothschild, Paris, France)
| | - M Schambelan
- (University of California, San Francisco, Calif., USA; to September 2000)
| | - R Puls
- (National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia)
| | - S Emery
- (National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia)
| | - A Moore
- (National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia)
| | - J Miller
- (National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia)
| | - A Carr
- (National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia)
| | - WH Belloso
- (Hospital Italiano de Buenos Aires, Buenos Aires)
| | - SA Ivalo
- (Hospital Italiano de Buenos Aires, Buenos Aires)
| | - LO Clara
- (Hospital Italiano de Buenos Aires, Buenos Aires)
| | - LA Barcan
- (Hospital Italiano de Buenos Aires, Buenos Aires)
| | - LD Stern
- (Hospital Italiano de Buenos Aires, Buenos Aires)
| | - AM Galich
- (Hospital Italiano de Buenos Aires, Buenos Aires)
| | - MI Perman
- (Hospital Italiano de Buenos Aires, Buenos Aires)
| | - M Losso
- (Hospital J M Ramos Mejía, Buenos Aires)
| | - A Duran
- (Hospital J M Ramos Mejía, Buenos Aires)
| | - J Toibaro
- (Hospital J M Ramos Mejía, Buenos Aires)
| | | | | | | | | | | | | | - A Carr
- (St Vincent's Hospital, Sydney)
| | | | | | | | - A Cain
- (Royal Perth Hospital, Perth)
| | - J Skett
- (Royal Perth Hospital, Perth)
| | | | - A Mijch
- (Alfred Hospital and Monash University, Melbourne)
| | - J Hoy
- (Alfred Hospital and Monash University, Melbourne)
| | - A Pierce
- (Alfred Hospital and Monash University, Melbourne)
| | - C McCormick
- (Alfred Hospital and Monash University, Melbourne)
| | - B De Graaf
- (Alfred Hospital and Monash University, Melbourne)
| | - J Falutz
- (Montreal General Hospital, Montreal)
| | | | - L Dion
- (Montreal General Hospital, Montreal)
| | | | | | | | | | - M Valyi
- (St Paul's Hospital, Vancouver)
| | | | | | | | - J Lundgren
- (Hvidovre University Hospital, Copenhagen)
| | - O Andersen
- (Hvidovre University Hospital, Copenhagen)
| | | | | | - P Mercié
- (Hôpital Haut-Lévêque, Bordeaux)
| | - G Chêne
- (Hôpital Haut-Lévêque, Bordeaux)
| | - J Reynes
- (Hôpital Gui de Chauliac, Montpellier)
| | - L Cotte
- (Hôpital Gui de Chauliac, Montpellier)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - P Reiss
- (Academic Medical Centre, University of Amsterdam and International AIDS Therapy Evaluation Center, Amsterdam)
| | - M van der Valk
- (Academic Medical Centre, University of Amsterdam and International AIDS Therapy Evaluation Center, Amsterdam)
| | - P Leunissen
- (Academic Medical Centre, University of Amsterdam and International AIDS Therapy Evaluation Center, Amsterdam)
| | - M Nievaard
- (Academic Medical Centre, University of Amsterdam and International AIDS Therapy Evaluation Center, Amsterdam)
| | - B van EckSmit
- (Academic Medical Centre, University of Amsterdam and International AIDS Therapy Evaluation Center, Amsterdam)
| | - C can Kujik
- (Academic Medical Centre, University of Amsterdam and International AIDS Therapy Evaluation Center, Amsterdam)
| | - N Paton
- (Tan Tock Seng Hospital, Singapore)
| | | | - F Karim
- (Tan Tock Seng Hospital, Singapore)
| | - C Y Khim
- (Tan Tock Seng Hospital, Singapore)
| | - S Ong
- (Tan Tock Seng Hospital, Singapore)
| | - J Gatell
- (Hospital Clinic Provincial de Barcelona)
| | - E Martinez
- (Hospital Clinic Provincial de Barcelona)
| | | | | | | | | | | | - A Bray
- (Sussex Hospital, Brighton)
| | - G Moyle
- (Chelsea and Westminster Hospital, London)
| | - C Baldwin
- (Chelsea and Westminster Hospital, London)
| | - C Higgs
- (Chelsea and Westminster Hospital, London)
| | - B Reynolds
- (Chelsea and Westminster Hospital, London)
| | | | | | - T Fiore
- (Miriam Hospital, Providence, RI)
| | | | - C Cohen
- (Community Research Initiative of New England, Brookline, Mass.)
| | - J Hellinger
- (Community Research Initiative of New England, Brookline, Mass.)
| | - K Foy
- (Community Research Initiative of New England, Brookline, Mass.)
| | - S Hubka
- (Community Research Initiative of New England, Brookline, Mass.)
| | - B Riccio
- (Community Research Initiative of New England, Brookline, Mass.)
| | - W El-Sadr
- (Harlem Hospital Center, New York, NY)
| | | | | | | | - S Miller
- (Harlem Hospital Center, New York, NY)
| | - S Hammer
- (Columbia University, New York, NY)
| | | | - S Chang
- (Columbia University, New York, NY)
| | - J Dobkin
- (Columbia University, New York, NY)
| | | | | | | | - H Kessler
- (Rush Presbyterian St Luke's Medical Center, Chicago, Ill.)
| | - A Tenorio
- (Rush Presbyterian St Luke's Medical Center, Chicago, Ill.)
| | - S Kjos
- (Rush Presbyterian St Luke's Medical Center, Chicago, Ill.)
| | - J Falloon
- (National Institute of Allergy and Infectious Diseases, Bethesda, Md.)
| | - HC Lane
- (National Institute of Allergy and Infectious Diseases, Bethesda, Md.)
| | - D Rock
- (National Institute of Allergy and Infectious Diseases, Bethesda, Md.)
| | - L Ehler
- (National Institute of Allergy and Infectious Diseases, Bethesda, Md.)
| | | | - T McClain
- (Denver Infectious Disease Consultants, Denver, Col.)
| | - R Murphy
- (Northwestern Memorial Hospital, Chicago, Ill.)
| | - P Milne
- (Northwestern Memorial Hospital, Chicago, Ill.)
| | - W Powderly
- (Washington University School of Medicine, St Louis, Mo.)
| | - J Aberg
- (Washington University School of Medicine, St Louis, Mo.)
| | - M Klebert
- (Washington University School of Medicine, St Louis, Mo.)
| | - M Conklin
- (Washington University School of Medicine, St Louis, Mo.)
| | - D Ward
- (Dupont Circle Physician's Group, Washington, DC)
| | - L Green
- (Dupont Circle Physician's Group, Washington, DC)
| | - B Stearn
- (Dupont Circle Physician's Group, Washington, DC)
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Duda SH, Bosiers M, Pusich B, Hüttl K, Oliva V, Müller-Hülsbeck S, Bray A, Luz O, Remy C, Hak JB, Beregi JP. Endovascular treatment of peripheral artery disease with expanded PTFE-covered nitinol stents: interim analysis from a prospective controlled study. Cardiovasc Intervent Radiol 2002; 25:413-8. [PMID: 12042992 DOI: 10.1007/s00270-002-1849-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Current covered peripheral stent designs have significant drawbacks in terms of stent delivery characteristics and flexibility. The aim of this study was to analyze the technical performance, safety and initial clinical efficacy of expanded polytetrafluoroethylene (PTFE)-covered nitinol stents for arteriosclerotic peripheral artery disease. METHODS Eighty-two patients underwent implantation of PTFE-covered nitinol stents for iliac and/or femoral obstructions. The study was conducted prospectively in seven European centers and one Canadian center. Patients were controlled clinically and by duplex ultrasound follow-up. Data up to discharge were collected in 79 patients. Seventy-four patients have thus far received 1 month follow-up and 32 patients, 6 month follow-up examinations. RESULTS The average lesion length measured 47 mm for the common and external iliac arteries and 50 mm for the femoral arteries. The mean severity of the stenoses was reduced from 94% to 4% in the iliac arteries and from 98% to 7% in the femoral arteries after stent placement and dilatation. One device deviation (inadvertent stent misplacement) and one puncture-related severe adverse event with formation of a pseudoaneurysm occurred. There were occlusions of the stent in five patients. No infections were noticed. CONCLUSION The interim analysis of this trial using PTFE-covered nitinol stents indicates that a strategy using primary implantation of this stent type is technically feasible, has an acceptable safety profile and is effective from a short-term perspective.
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Affiliation(s)
- S H Duda
- Division of Diagnostic Radiology, Department of Radiology, University of Tübingen, Tübingen, Germany.
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Bray A, Gates S. In that case: Geoff is a 25-year-old man who is a patient of the nephrology unit at a local hospital. Commentary. N Z Bioeth J 2001; 2:39-41. [PMID: 15696631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- A Bray
- Donald Beasley Institute Inc., New Zealand
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Abstract
OBJECTIVES To describe the radiological features of primitive neuroectodermal tumour (PNET) of the chest wall (Askin tumour) at diagnosis and to analyse the radiological changes occurring as a consequence of treatment and during follow-up. MATERIALS AND METHODS Nine children with histologically proven PNET were studied. At diagnosis, all patients underwent chest X-ray (CXR), chest CT and bone scintigraphy; three patients also had MR and three had US. During treatment and follow-up, CT was performed in all patients. RESULTS CT demonstrated a solid heterogeneous chest wall mass in all children at diagnosis and six had a rib lesion. Small nodular densities in the extra-pleural fat were identified in three patients at diagnosis. US, performed in three patients, excluded tumour infiltration of the lung or diaphragm, which had been suspected on CT. On MR, the lesions showed high signal intensity in T1-weighted/proton-density images and intermediate/high signal intensity in T2-weighted images compared with muscle. Minimal chest wall involvement was demonstrated in one case by MRI. Extensive necrosis of tumour mass with pseudo-cystic appearance was documented in the five patients who underwent chemotherapy. Macroscopically complete resection was performed in five patients but there was early local recurrence after surgery in two, identified by CT in one and by MR in the other. CONCLUSIONS PNET of the chest wall should be considered in a child with a chest wall mass. CT is valuable for evaluating tumour extension at diagnosis, the effects of chemotherapy and assessing tumour recurrence after surgery. However, CT can overestimate pleural, lung or diaphragmatic infiltration, which are better evaluated by US. MR was superior to CT in the evaluation of tumour extension in one of three patients and may be considered complementary to CT, particularly in very large chest wall tumours.
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Affiliation(s)
- G Sallustio
- Radiology Department, Catholic University of Rome, Largo A. Gemelli 8, I-00 168 Rome, Italy
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Abstract
We report an unusual evolution of turpentine-induced pneumonia due to accidental aspiration in a 21-month-old child. Chest X-rays demonstrated patchy alveolar densities evolving into large pneumatoceles. Follow-up CT optimally depicted the number, site and extent of pneumatoceles. To our knowledge, pneumatoceles developing in turpentine-induced pneumonia have never been reported in turpentine aspiration.
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Affiliation(s)
- A Bray
- Department of Radiology, "A. Gemelli" University Hospital, Catholic University of Rome, Largo Agostino Gemelli, 8, I-00 168 Rome, Italy
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Guida A, Pirronti T, Matteucci S, Bray A. [Thrombophlebitis of the jugular vein: a correlation between echography and computed tomography with angiography. A case report]. Radiol Med 1997; 94:396-7. [PMID: 9465251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- A Guida
- Servizio di Radiologia, Ospedale S. Paolo, Civitavecchia, Roma
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Di Gregorio F, Bray A, Pedicelli A, Settecasi C, Priolo F. Diagnostic imaging of the diabetic foot. Rays 1997; 22:550-61. [PMID: 9550896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Diagnostic imaging plays a major role in the osteoarticular disease of the foot in diabetics, allowing the diagnosis and evaluation of alterations for therapy planning. To-date conventional radiology is still of first choice in the study of the diabetic foot with the evaluation of osteoarticular damage caused by neuropathy and vascular disease. Major radiographic patterns are neuroarthropathy and osteomyelitis. Main locations are at the level of forefoot and less frequently of tarsus and tibiotarsal joint. Second choice procedures as US, CT and MRI are useful for a more accurate evaluation of soft tissue lesions and articular structures. US is the first choice procedure in soft tissue evaluation to rule out the presence of abscesses which require surgery. MRI with some limitations represents the gold standard for the study of joints and medullary disease. Spiral CT though less specific and sensitive than MRI for soft tissue and bone marrow study is still the exam of reference for the study of bone structures with three-dimensional reconstructions useful to plan orthopedic surgery.
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Affiliation(s)
- F Di Gregorio
- Istituto di Radiologia, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Roma, Italy
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Sallustio G, Bray A, Colavito MH, Pirronti T, Marano P. High resolution computed tomography (HRCT) and new perspectives in functional radiology of the lung. Rays 1997; 22:157-82. [PMID: 9145020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Computed Tomography (CT) with the advent of new techniques as high resolution computed tomography (HRTC) and spiral CT with 3D reconstructions (3D CT) allows a new morphologic-qualitative as well as functional-quantitative evaluation of pulmonary perfusion and ventilation. HRCT allows the identification of secondary lobule and a detailed morphologic and comparative analysis of minute distal anatomical structures with combined densitometric evaluation of lung parenchyma on perfusion. In particular, a new, more specific significance could be attributed to changes in density of lung parenchyma (mosaic pattern) with associated assessment of the vessel number, caliber and distribution, and a comparative evaluation of vessels and density between healthy and impaired areas. The "optical" HRCT evaluation on serial axial scans in inspiration and expiration allows the functional assessment of compartments which require spirometry and tests of respiratory function. Spiral CT allows volumetric acquisitions in a single breath which can be reconstructed and processed according to single requirements. 3D tailored reconstruction of spiral CT exam in maximum inspiration and expiration with a dedicated densitometric window (-1024/+ 100 HU) allows the calculation of total lung volume (TLV), of both lungs, of a single lung or selected sections. With the "air" densitometric window (-1024/-400 HU) the total lung capacity (TLC) and residual volume (RV) are calculated. The ratio between these values and the corresponding TLV represents the lung aeration index (LAI). 3D reconstruction with fixed densitometric value corresponding to median air density (peak of histogram) allows the scintigraphic-like "alveolographic" reconstruction of lung ventilation. Combined 3D CT and HRCT evaluation possibly from a single spiral CT exam, is used in the morphologic-functional diagnosis of respiratory pathophysiology.
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Affiliation(s)
- G Sallustio
- Istituto di Radiologia, Università Cattolica del S. Cuore, Policlinico A. Gemell, Roma, Italy
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Bloem JL, Geirnaerdt MJA, Hogendoorn PCW, Chevrot A, Davies AM, Hájek M, Kurková D, Herynek V, Imhof H, Masciocchi C, Maffey MV, Møller JF, Putz R, Reiser MF, Braunschweig R, Bonél H, Stäbler A, Watt I, Adams JE, Harake MDJ, Lipscomp K, Selby PL, Aparisi F, Arana E, Lloret RM, Marti-Bonmati I, Menor F, Sanchez E, Rodrigo C, Beltran J, Cifrian C, Garci JL, Memis A, Arkun R, Akalin T, Ustu EE, Sabah D, Barile A, Rossi F, Zugaro L, Manetta R, Maurizi Enrici R, Beggs I, Bianchi S, Martinoli C, Molini L, Gandolfo N, Damiani S, Helmberger T, Sittek H, Steinborn M, Ritter MM, Geisst HC, Pistitsch C, Herrmann K, Bögl K, Kainberger F, Adlassnig KP, Kolousek G, Leitich H, Kolarz G, Bracke P, Ramon F, Stevens W, De Clarck L, De Schepper A, Sys J, Michielsen J, Martens M, Breitenseher MJ, Trattnig S, Gaebler C, Metz V, Kukla C, Gneger A, Rand T, Brossmann J, Andresen R, Preidler KW, Daenen B, DeMaeseneer M, Resnick D, Burnett S, Saifuddin A, White J, Cassar-Pullicino VN, Inman C, Griffiths J, McCall IW, Masri WE, Csókási Z, Forgacs S, Czerny C, Neuhold A, Hofmann S, Tschauner C, Engel A, Recht MP, Kramer J, DeBeuckeleer L, DeSchepper A, Somerville J, Vandevenne J, De Maeseneer M, Jaovishidha S, Sartoris DJ, Elizagaray E, Saez F, Faletti C, De Stefano N, Sorrentin T, Foderà Pierangeli L, Mona D, Foster JE, Taberner J, Keen M, Dieppe P, Freyschmidt J, Gibbon WW, O'Connor PJ, McGonagle D, Emery P, Grampp S, Lang P, Jergas M, Glüer CC, Steiner E, Takada M, Mathur A, Genant HK, Jevtic V, Rozman B, Kos-Golja M, Demsar F, Nehrer S, Seidl G, Baldt M, Klarlund M, Østergaard M, Sørensen K, Lorenzen I, Eschberger J, Gstettner M, Schneider W, Plenk H, Kühne JH, Steinborn A, Dürr HR, Scheidler J, Lienemann A, Landsiedl F, Mamdorff P, Honda G, Rosenau W, Johnston J, Mindell E, Peterfy CG, Nevitt M, Majumdar S, Lecouvet FE, Vande Berg BC, Maighem J, Michaux JL, Maldague BE, Lecoevet FE, Malghem J, Mastantuono M, Larciprete M, Bassetti E, Argento G, Amoroso M, Satragno L, Nucci F, Romanini L, Passariello R, McNally EG, Goodman TR, Merkle EM, Krammel E, Vogel J, Krämer S, Schulte M, Usadel S, Kern P, Brambs HJ, Mester Á, Makó E, Papp E, Kiss K, Márton E, Dévai T, Duffek L, Bártfai K, Németh L, Karlinger K, Posgay M, Kákosy T, Davies GA, Cowen AR, Fowler RC, Bury RF, Parkin GJS, Lintott DJ, Martinez D, Safadin A, Pal CR, Ostlere SJ, Phillps AJ, Athanasou N, Lemperle SM, Holmes RE, Rühm S, Zanetti M, Romero J, Hodler J, Larena JA, Marti-Bonmarti L, Martin I, Tabernero G, Alonso A, Scarabino T, Guglielmi G, Giannatempo GM, Cammisa M, Salvolini U, Schmitt R, Fellner F, Heinze A, Obletter N, Schnarkowski P, Tirman PFJ, Steinbach LS, Schneider P, Ferrettiz JL, Capozza RF, Braun M, Reiners C, Zettl R, Silvestri E, Falchi M, Delucchi S, Cella R, Neumaier CE, Prato N, Migliorini S, Jessel C, Heuck A, Stevens KJ, Preston BJ, Kerslake RW, Wright W, Wallace WA, Stiskal M, Szolar D, Stenzel I, Mesaric P, Smolen J, Czembirek H, Tasker AD, Benson MK, Fleischmann D, Haller J, Rottmann B, Kontaxis G, Vanel D, Missenard G, Le Cesne A, Guinebretiere JM, Verhoek G, Duewell S, Zollinger H, Vrooman HA, Valstar ER, Brand GJ, Obermann WR, Rozing PM, Reiber JHC, Zafiroski G, Kamnar J, Zografski G, Jeftic V, Vidoevski G, Ledermann T, Zerbi A, Gambaretti R, Trenti N, Zanolla W, Allen AW, Willis CE, Radmer S, Hakim S, Banzer D, Sparmann M, Argent JD, Sampson MA, Baur A, Bartl R, Llopis E, Monton T, Vallcanera A, Serafini G, Bertolotto M, Trudell D, White LM, Garlaschi G, DiLella GM, Bray A, Parrella A, Salvia F, Parrella RE, Esztergályos J, Faul S, Link J, Behrendt S, Helbich T, Steingruber I, Gahleitner A, Kettenbach J, Kreuzer S, Lomoschitz F, Kaposi PN, Reti PG, Kolenc M, Turk Z, Barovic J, Kugler C, Uggowitzer M, Gröll R, Raith J, Ranner G, Liskutin J, Youssefzadeh S, Montagnon C, Billiard JS, Tanji P, Peerally S, Gazielly D, Muhaz-Vives JM, Fernández J, Girveni-Montilos R, Catasuz-Capellades X, Valls-Pascual R, Niitsu M, Mishima H, Itai Y, Pirronti T, Sallustio G, Cerase A, Priolo F, Poleksic L, Atanackovic M, Dimitrijevic B, Bacic G, Potsybina VV, Rangger C, Kathrein A, Klestil T, Gabl M, Daniaux H, Recondo JA, Alustiza JM, Villanua J, Barrera MC, Salvador E, Larrea JA, Martin J. The 3rd annual congress of the European society of skeletal radiology. Eur Radiol 1996. [DOI: 10.1007/bf00187690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Parrella RE, Bray A, Di Lella GM, Parrella A, Salvia F. [Diagnostic imaging of bilateral hyperplasia of the mandibular coronoid process. A case report]. Radiol Med 1996; 92:477-8. [PMID: 9045253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- R E Parrella
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma
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Abstract
We suggest that the criteria for antisocial personality disorder, or "sociopathy", in the Diagnostic and statistical manual of mental disorders (4th edition) are deficient in that they define "failed sociopathy", and fail to include an equally valid group of individuals who, although seen by society as successful, display core features of the antisocial personality disorder.
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Affiliation(s)
- M D Robertson
- Department of Psychiatry, Royal Prince Alfred Hospital, Sydney, NSW, Australia
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Abstract
The following data are required when reporting results of a procedure for occlusive disease of the lower limb: (1) PREOPERATIVE PATIENT ASSESSMENT: This should include age, sex, diabetes, smoking habit, whether the ischemic symptoms are at rest or after exercise, and the resting ankle or toe pressure. (2) INTENTION TO TREAT: This should be stated as a percentage of the number of procedures that actually were properly performed against the number of procedures scheduled. Only those procedures that were performed should be subsequently analyzed. (3) ACUTE RESULTS: This is assessed by an imaging technique, such as angiography or duplex ultrasound, and defined in terms of patency and degree of maximal stenosis in the area treated and 5 cm on either side. Change in symptoms, complications, and ankle pressures should be reported but are not criteria for procedural success or failure. The assessment should be done from 10 to 30 days following the procedure. (4) LONG-TERM RESULTS: As assessed by appropriate imaging techniques, outcome should be reported in terms of primary, assisted primary, and secondary patency. The degree of maximal stenosis in the treated segments and 5 cm on either side should be stated. The surveillance intervals would depend on the answers being sought in the follow-up period, but the minimum would be an annual review. Three-year results are required to give an adequate assessment of the durability of a procedure. (5) REPORTING: Life-table analysis should be used to present the data on patencies and the degree of stenosis.
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Affiliation(s)
- A Bray
- Cardio-Vascular Centre, Newcastle, Australia
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Abstract
The records of 305 consecutive patients who had presented with cosmetic symptoms related to varicose and/or spider veins over a 12-month period were studied. Following clinical assessment, 250 (82%) patients were referred for duplex venous imaging. A total of 500 lower limbs were evaluated; 236 (47%) were documented to have incompetence in the superficial venous system (long or short saphenous veins). Only 6 (1%) limbs had deep venous incompetence and 45 (9%) limbs were found to have perforator incompetence. Short saphenous vein incompetence was found in 59 (12%) limbs. In the long saphenous vein there was a consistent pattern of an increasing incidence of incompetence from the saphenofemoral junction down to the below-knee segment. The duplex imaging findings were applied to determine the optimal treatment, ie, whether surgery, sclerotherapy, or a combination of both would provide the best short- and long-term results. The possible etiology and pathophysiology of spider and varicose veins are discussed in relation to these results.
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Murdoch L, Bray A. Another use of the pulse oximeter. Anaesthesia 1989. [DOI: 10.1111/j.1365-2044.1989.tb11428.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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29
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Green M, Howard JAK, Bray A, Johnson O, Stone FGA. Synthesis and molecular structures of related tri-nuclear rhodium complexes. Acta Crystallogr A 1984. [DOI: 10.1107/s0108767384091248] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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30
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Raaf J, Bryan C, Monden M, Bray A, Kim JH, Chu F, Chaganti RS, Shank B, Cahan A, Fortner JG. Bone marrow and renal transplantation in canine recipients prepared by total lymphoid irradiation. Transplant Proc 1981; 13:429-33. [PMID: 7022866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
Inflammatory cell populations from synovial effusions or synovial villi in rheumatoid arthritis have been cultured in vitro. Prostaglandin productive capacity, measured by radioimmunoassay, showed the polymorphonuclear leucocyte rich populations from synovial effusions to be poor sources of PGE production whereas the synovial fragments produced substantial amounts of PGE activity. It is suggested that the macrophage is the major source of local prostaglandin formation both in gout and rheumatoid arthritis.
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