Parents’ received and expected information about their child’s radiation exposure during radiographic examinations

Abstract

Background

Despite regulations, insufficient information is provided to adult patients prior to their radiologic examinations. Information regarding paediatric patients has not been systematically studied.

Objective

To survey parents' experience and wishes for information in connection with their child's radiographic examination.

Materials and methods

We provided a questionnaire to consenting parents of children younger than 12 years old at a university hospital. The questionnaire asked parents about the information obtained from the referrer prior to the radiograph, the chance to discuss with the referrer and their wishes regarding future information. Forty-one parents responded to the survey. Twenty-five children were referred for radiography of extremities, the others for dental, body and skull examinations.

Results

Altogether 34/41 (83%, 95% confidence interval [CI] 69–91%) parents said they received adequate information on the purpose of the examination, 8/35 (23%, 95% CI 12–39%) on other options and 3/41 (7%, 95% CI 3–19%) on radiation dose. Ten of 41 parents (24%, 95% CI 12–40%) said they were aware of radiation exposure. The number of previous radiology examinations was not sufficiently discussed. The communication was scored as mean 6.5 (95% CI 5.8–7.1) on a scale from 4 (poor) to 10 (excellent). Thirty-eight of 40 (95%, 95% CI 84–99%) of parents expected information on the purpose, 35/40 (88%, 95% CI 74–95%) on radiation dose and 31/40 (78%, 95% CI 63–88%) on other options. Symbols of radiation and corresponding period of natural background radiation are preferred to convey the dose. A referrer is the preferred source of information.

Conclusion

Parents did not feel adequately informed prior to their child's radiographic examination. Parents expect more information about the purpose, dose and alternative tests.

from Imaging via a.sfakia on Inoreader https://ift.tt/2qGbPiE

Food OIT is Superior to Food Avoidance

Over the last decade much attention has focused on the possibility of using oral immunotherapy (OIT) as a therapeutic approach for treatment of IgE-mediated food allergies, a disease without a Food and Drug Administration (FDA)-approved disease-modifying therapy. Peanut allergy has been a particular concern because of its persistent nature and association with potentially life-threatening reactions. The OIT literature has been criticized for heterogeneity in trial design with disparities in identification of allergic individuals by double blind placebo controlled food challenges (DBPCFC), differences in desensitization approaches and maintenance doses of allergen, absence of a standardized product, inconsistency in the primary endpoint (e.g.

from Allergy and Immunology via a.sfakia on Inoreader https://ift.tt/2qI49fL

An Ounce of Caution: Superparamagnetic Iron Oxide Nanoparticle Based MRI Contrast Associated Anaphylaxis

Superparamagnetic iron oxide nanoparticles (SPIONs) are increasingly utilized alternatives to gadolinium-based Magnetic Resonance Imaging (MRI) contrast agents in the diagnosis of osteomyelitis in diabetic patients with renal failure [1]. Ferumoxytol is approved by the United States Food and Drug Administration (FDA), the European Medicines Agency, for intravenous (IV) use for iron replacement therapy [1-3]. Ferumoxytol is composed of an iron-carbohydrate complex that minimizes dissociation and appearance of free iron into the serum.

from Allergy and Immunology via a.sfakia on Inoreader https://ift.tt/2QEECiY

The Effect of Delayed and Early Diagnosis in Siblings, and Importance of Newborn Screening for SCID

Severe combined immunodeficiency (SCID) is a form of primary immunodeficiency that affects both cellular and humoral immunity, caused by genetic defects in lymphocyte development and function. There are over 20 known genes mutations that lead to SCID including defects that cause radiosensitivity due to impairment in DNA repair (1). Mutations in DCLREC1 resulting in absent or dysfunctional Artemis protein are the most common cause of SCID associated with increased radiosensitivity and were identified as the etiology of the unusually high incidence of T-B-NK+ SCID in Athabascan-speaking tribes, Apache and Navajo (2,3).

from Allergy and Immunology via a.sfakia on Inoreader https://ift.tt/2qJc1xO

Reliable manifestations of increased intracranial pressure in patients with syndromic craniosynostosis

Systematic examination of increased intracranial pressure (ICP) is important during the follow-up period after surgical repair of syndromic craniosynostosis. In these patients, postoperative progress can be unclear due to the involvement of multiple sutures and the high incidence of relapse due to the progressive nature of the disease and to genetic variability. In this study, we investigated the clinical manifestations of increased ICP in syndromic craniosynostosis patients before and after surgery.

from OroFacial via a.sfakia on Inoreader https://ift.tt/2ODz5HL

Secondary alveolar bone grafting in cleft lip and palate: A comparative analysis of donor site morbidity in different age groups

There is no consensus regarding the optimal timing for secondary alveolar bone grafting for clefts defects. We aimed to investigate the potential correlation between the age of patients during surgery, donor site symptoms, surgical time and hospitalization following this procedure.

from OroFacial via a.sfakia on Inoreader https://ift.tt/2z9EJfA

Cyanoacrylate tissue adhesive or silk suture for closure of surgical wound following removal of an impacted mandibular third molar: A randomized controlled study

The aim of the study was to compare postoperative sequelae and wound healing outcome following closure of surgical wound with either cyanoacrylate tissue adhesive or silk suture.

from OroFacial via a.sfakia on Inoreader https://ift.tt/2OIiSRH

An in-vitro evaluation of a novel design of miniplate for fixation of fracture segments in the transition zone of parasymphysis-body region of mandible using finite element analysis

The mandibular parasymphysis and body regions are highly dynamic areas. They are constantly subjected to both occlusal and muscular forces. Fractures at this transition zone of the parasymphysis and body region thus represent a special pattern that creates a dilemma for the surgeons — whether to use one miniplate fixation or two miniplates as per Champy's guidelines. Mental nerve paresthesia is a very common complication due to dissection and stretching of the mental nerve in this region. Hence, an in-vitro research study of a novel twin fork design of miniplate is performed, which evaluates the biomechanical behavior using computerized finite element analysis.

from OroFacial via a.sfakia on Inoreader https://ift.tt/2z5kkIu

Comparison of rim-sparing versus rim-removal techniques in deep lateral wall orbital decompression for Graves’ orbitopathy

The aim of this study was to compare the surgical outcomes of deep lateral orbital decompression using the rim-sparing technique versus the rim-removal technique in Graves' orbitopathy (GO). A retrospective cohort study of 75 orbits in 50 patients with GO was performed. Proptosis, best corrected visual acuity (BCVA), intraocular pressure (IOP), upper and lower lid margin to reflex distances (MRD-1 and MRD-2, respectively), diplopia, ocular restriction, and GO quality of life (GO-QOL) questionnaire results were analyzed pre- and postoperatively.

from OroFacial via a.sfakia on Inoreader https://ift.tt/2qJ6R4U

Cost analysis of oral and maxillofacial free flap reconstruction for patients at an institution in China

Free flap transplantation has become a mainstay for the restoration of oral and maxillofacial defects. However, the complexity of the surgical procedure and long hospitalization time result in high hospitalization costs. This study was performed to retrospectively analyse the composition of hospitalization expenses and factors influencing this for 507 patients who underwent oral and maxillofacial free flap transplantation at a representative medical institution in China. The aim was to provide evidence for the reasonable control of expenditure and effective utilization of medical resources, and to gain an indirect reflection of the healthcare model characteristics of public hospitals in China.

from OroFacial via a.sfakia on Inoreader https://ift.tt/2FjE2pL

Effects of auriculotherapy and midazolam for anxiety control in patients submitted to third molar extraction

Anxiety is common and still represents a barrier to appropriate professional care for patients requiring dental treatment. The aim of this study was to compare the effects of auriculotherapy and midazolam for the control of anxiety in patients submitted to third molar extractions. This was a randomized, double-blind, controlled, crossover clinical trial. Thirty healthy volunteers requiring bilateral third molar extraction received midazolam 15mg (oral) and sham auriculotherapy during one session, and a placebo tablet (oral) and auriculotherapy during the other; the sessions were randomized.

from OroFacial via a.sfakia on Inoreader https://ift.tt/2qKhDaW

Response to the Letter to the Editor regarding “Impact of crack cocaine use on the occurrence of oral lesions and micronuclei”

We are grateful for the interest in our study "Impact of crack cocaine use on the occurrence of oral lesions and micronuclei"1. Firstly, regarding the criticism that Giemsa stain can cause false-positive results, we agree that this method may provide an overestimate of the presence of micronuclei. However, any misclassification would be non-differential, as a difference in the overestimation between groups is not plausible. Thus, this type of error would bias the results towards the null hypothesis2 and therefore does not account for the differences described in our study between crack users and non-users.

from OroFacial via a.sfakia on Inoreader https://ift.tt/2Fgyj3K

A Preliminary Study of Vocal Health Among Collegiate A Cappella Singers

Collegiate a cappella groups have grown significantly in popularity and prominence; however, there have been few studies that evaluate the vocal health of this subgroup of young singers. The objective of this preliminary study was to conduct a multiparametric evaluation of the vocal health characteristics of a sample of collegiate a cappella singers. We further tested whether differences in vocal health assessments exist between a cappella singers with and without vocal training and trained collegiate singers who do not participate in a cappella groups.

from Speech via a.sfakia on Inoreader https://ift.tt/2Fegfr4

Germination of pollen grains in the esophagus of individuals with eosinophilic esophagitis

Abstract

Background

Eosinophilic esophagitis (EoE) is characterized by esophageal dysfunction and, histologically, by eosinophilic inflammation. There is no a clear etiologic treatment. EoE exacerbations are often seasonal. We hypothesized that the inflammatory response of the esophageal mucosa in patients with high levels of antibodies to pollen allergens and worsened seasonal EoE might be due to swallowing airborne pollen and the intrusion into the esophageal mucosa of pollen allergens and pollen tubes, which encounter a pH and humidity resembling the stigma at pollination.

Objective

The aim of our study was to demonstrate the possible pathogenic role of environmental allergens in EoE through molecular and anatomopathological studies.

Methods

129 patients with EoE were tested for environmental and food allergens. Component resolved diagnosis (CRD), histological and botanical analysis was performed. Microscopic examination of esophageal biopsies of 129 adults patients with EoE, 82 of them with seasonal exacerbation, and 100 controls, with gastroesophageal reflux without eosinophilic infiltrate, were made to verify the presence of callose (polysaccharide abundant in pollen tubes but absent in animal tissues) in the esophagus.

Results

CRD detected pollen allergens in 87.6% of patients with EoE. The predominant allergens were group 1 grass (55%), Art v 3 (11.3%) and lipid transfer proteins (LTPs) (19.4%) of common Mediterranean foods such as peach, hazelnuts, walnuts and wheat. Callose from pollen tubes was found in 65.6% of biopsies.

Conclusion

Alteration of the mucosal barrier in EoE might cause the penetration of pollen grains into the esophageal tissues. In EoE patients, anatomopathological studies searching for intrusion to plant foods and pollen, and specific‐guided diet and immunotherapy after plant structures detection in biopsies, might be effective.

This article is protected by copyright. All rights reserved.

from Allergy and Immunology via a.sfakia on Inoreader https://ift.tt/2zICK1e

Massive release of the histamine‐degrading enzyme diamine oxidase during severe anaphylaxis in mastocytosis patients

Abstract

Background

Histaminolytic activity mediated by diamine oxidase (DAO) is present in plasma after induction of severe anaphylaxis in rats, guinea pigs and rabbits. Heparin released during mast cell degranulation in the gastrointestinal tract might liberate DAO from heparin‐sensitive storage sites. DAO release during anaphylaxis has not been demonstrated in humans.

Methods

Plasma DAO, tryptase and histamine concentrations of four severe anaphylaxis events were determined at multiple serial time points in two patients with systemic mastocytosis. The histamine degradation rates were measured in anaphylaxis samples and in pregnancy sera and plasma with comparable DAO concentrations.

Results

Mean DAO (132 ng/ml) and tryptase (304 ng/ml) concentrations increased 187‐ and 4.0‐fold respectively over baseline values (DAO 0.7 ng/ml, tryptase 76 ng/ml) during severe anaphylaxis. Under non‐anaphylaxis conditions DAO concentrations were not elevated in 29 mastocytosis patients compared to healthy volunteers and there was no correlation between DAO and tryptase levels in mastocytosis patients. The histamine degradation rate of DAO in plasma from mastocytosis patients during anaphylaxis is severely compromised compared to DAO from pregnancy samples.

Conclusions

During severe anaphylaxis in mastocytosis patients DAO is likely released from heparin‐sensitive gastrointestinal storage sites. The measured concentrations can degrade histamine, but DAO activity is compromised compared to pregnancy samples. For accurate histamine measurements during anaphylaxis DAO inhibition is essential to inhibit further histamine degradation after blood withdrawal. Determination of DAO antigen levels might be of clinical value to improve the diagnosis of mast cell activation.

This article is protected by copyright. All rights reserved.

from Allergy and Immunology via a.sfakia on Inoreader https://ift.tt/2T3rupc

Imaging in Pancreatic Adenocarcinoma: DAMS Unplugged

Pancreatic ductal adenocarcinoma has poor prognosis and high morbidity. It appears poorly marginated hypodense mass which may encase vessels and the common biliary duct. Presenting an integrated approach in DAMS unplugged video.

Famous Radiology Blog https://ift.tt/1MM2hKr TeleRad Providers at https://ift.tt/1NgppuI Mail us at sales@teleradproviders.com

from Imaging via a.sfakia on Inoreader https://ift.tt/2Pq7JtC

Three cases of food protein-induced enterocolitis syndrome caused by egg yolk

Publication date: Available online 12 November 2018

Source: Allergology International

Author(s): Masaki Shimomura, Hiroki Tanaka, Takaaki Meguro, Mitsuaki Kimura

from Allergy and Immunology via a.sfakia on Inoreader https://ift.tt/2qJ7tay

CD3+CD4-CD8- mucosal T cells are associated with uncontrolled chronic rhinosinusitis with nasal polyps

Publication date: Available online 12 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Tanja Soklic Kosak, Mira Silar, Matija Rijavec, Ana Koren, Izidor Kern, Irena Hocevar Boltezar, Peter Korosec

from Allergy and Immunology via a.sfakia on Inoreader https://ift.tt/2T9Vgc7

Th9 immunodeficiency in Hyper IgE syndrome patients

Publication date: Available online 12 November 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Matthew R. Olson, Mark H. Kaplan

from Allergy and Immunology via a.sfakia on Inoreader https://ift.tt/2zOSTSU

Influence of Artificial Intelligence on Canadian Medical Students' Preference for Radiology Specialty: A National Survey Study

Publication date: Available online 11 November 2018

Source: Academic Radiology

Author(s): Bo Gong, James P. Nugent, William Guest, William Parker, Paul J. Chang, Faisal Khosa, Savvas Nicolaou

Rationale and Objectives

Artificial intelligence (AI) has the potential to transform the clinical practice of radiology. This study investigated Canadian medical students' perceptions of the impact of AI on radiology, and their influence on the students' preference for radiology specialty.

Materials and Methods

In March 2018, an anonymous online survey was distributed to students at all 17 Canadian medical schools.

Results

Among 322 respondents, 70 students considered radiology as the top specialty choice, and 133 as among the top three choices. Only a minority (29.3%) of respondents agreed AI would replace radiologists in foreseeable future, but a majority (67.7%) agreed AI would reduce the demand for radiologists. Even among first-choice respondents, 48.6% agreed AI caused anxiety when considering the radiology specialty. Furthermore, one-sixth of respondents who would otherwise rank radiology as the first choice would not consider radiology because of the anxiety about AI. Prior significant exposure to radiology and high confidence in understanding of AI were shown to decrease the anxiety level. Interested students valued the opinions of local radiologists, radiology conferences, and journals. Students were most interested in "expert opinions on AI" and "discussing AI in preclinical radiology lectures" to understand the impact of AI.

Conclusion

Anxiety related to "displacement" (not "replacement") of radiologists by AI discouraged many medical students from considering the radiology specialty. The radiology community should educate medical students about the potential impact of AI, to ensure radiology is perceived as a viable long-term career choice.

from Imaging via a.sfakia on Inoreader https://ift.tt/2QBguxP

PET/TC con 18F-FDG en cáncer de cérvix localmente avanzado

Publication date: Available online 11 November 2018

Source: Revista Española de Medicina Nuclear e Imagen Molecular

Author(s): A.P. Caresia-Aróztegui, R.C. Delgado-Bolton, S. Alvarez-Ruiz, M. del Puig Cózar-Santiago, J. Orcajo-Rincon, M. de Arcocha-Torres, M.J. García-Velloso, en nombre del Grupo de Trabajo de Oncología de la Sociedad Española de Medicina Nuclear e Imagen Molecular

Resumen

El cáncer de cérvix es el segundo cáncer ginecológico en frecuencia a nivel mundial. En tumores localmente avanzados la PET/TC con ¹⁸F-FDG tiene un papel relevante en la detección de enfermedad ganglionar y a distancia, factores en los que se basan el tratamiento y el pronóstico de estas pacientes.

El objetivo de este trabajo es revisar las indicaciones actuales de la PET/TC con ¹⁸F-FDG en el cáncer de cérvix para cada una de las principales sociedades científicas (FIGO, NCCN, SEGO, SEOM, ESGO, ESMO) y la rentabilidad diagnóstica de la prueba comparada con las técnicas radiológicas convencionales, así como el procedimiento y su utilidad en la planificación de la radioterapia, en la valoración de respuesta y en la detección de recidiva.

Abstract

Cervical cancer is the second most common gynecological cancer worldwide. In locally advanced cervical cancer, ¹⁸F-FDG PET/CT has become important in the initial staging, particularly in the detection of nodal and distant metastasis, aspects with treatment implications and prognostic value.

The aims of this study were to review the role of ¹⁸F-FDG PET/CT in uterine cervical cancer, according to the guidelines of the main scientific institutions (FIGO, NCCN, SEGO, SEOM, ESGO, and ESMO) and its diagnostic accuracy compared to conventional radiological techniques, as well as to review the acquisition protocol and its utility in radiotherapy planning, response assessment and detection of recurrence.

from Imaging via a.sfakia on Inoreader https://ift.tt/2z78jlW

The role of experience for abstract concepts: Expertise modulates the electrophysiological correlates of mathematical word processing

Publication date: January 2019

Source: Brain and Language, Volume 188

Author(s): Laura Bechtold, Christian Bellebaum, Sophie Egan, Marco Tettamanti, Marta Ghio

Abstract

Embodied theories assign experience a crucial role in shaping conceptual representations. Supporting evidence comes mostly from studies on concrete concepts, where e.g., motor expertise facilitated action concept processing. This study examined experience-dependent effects on abstract concept processing. We asked participants with high and low mathematical expertise to perform a lexical decision task on mathematical and nonmathematical abstract words, while acquiring event-related potentials. Analyses revealed an interaction of expertise and word type on the amplitude of a fronto-central N400 and a centro-parietal late positive component (LPC). For mathematical words, we found a trend for a lower N400 and a significantly higher LPC amplitude in experts compared to nonexperts. No differences between groups were found for nonmathematical words. The results suggest that expertise affects the processing stages of semantic integration and memory retrieval specifically for expertise-related concepts. This study supports the generalization of experience-dependent conceptual processing mechanisms to the abstract domain.

from Speech via a.sfakia on Inoreader https://ift.tt/2OEPPOG

Spoken language coding neurons in the Visual Word Form Area: Evidence from a TMS adaptation paradigm

Publication date: Available online 12 November 2018

Source: NeuroImage

Author(s): Chotiga Pattamadilok, Samuel Planton, Mireille Bonnard

Abstract

While part of the left ventral occipito-temporal cortex (left-vOT), known as the Visual Word Form Area, plays a central role in reading, the area also responds to speech. This cross-modal activation has been explained by three competing hypotheses. Firstly, speech is converted to orthographic representations that activate, in a top-down manner, written language coding neurons in the left-vOT. Secondly, the area contains multimodal neurons that respond to both language modalities. Thirdly, the area comprises functionally segregated neuronal populations that selectively encode different language modalities. A transcranial magnetic stimulation (TMS)-adaptation protocol was used to disentangle these hypotheses. During adaptation, participants were exposed to spoken or written words in order to tune the initial state of left-vOT neurons to one of the language modalities. After adaptation, they performed lexical decisions on spoken and written targets with TMS applied over the left-vOT. TMS showed selective facilitatory effects. It accelerated lexical decisions only when the adaptors and the targets shared the same modality, i.e., when left-vOT neurons had initially been adapted to the modality of the target stimuli. Since this within-modal adaptation was observed for both input modalities and no evidence for cross-modal adaptation was found, our findings suggest that the left-vOT contains neurons that selectively encode written and spoken language rather than purely written language coding neurons or multimodal neurons encoding language regardless of modality.

from Imaging via a.sfakia on Inoreader https://ift.tt/2T3Ljg1

Age-related changes in brain deactivation but not in activation after motor learning

Publication date: Available online 12 November 2018

Source: NeuroImage

Author(s): K.M.M. Berghuis, S. Fagioli, N.M. Maurits, I. Zijdewind, J.B.C. Marsman, T. Hortobágyi, G. Koch, M. Bozzali

Abstract

It is poorly understood how healthy aging affects neural mechanisms underlying motor learning. We used blood-oxygen-level dependent (BOLD) contrasts to examine age-related changes in brain activation after acquisition and consolidation (24 h) of a visuomotor tracking skill. Additionally, structural magnetic resonance imaging and diffusion tensor imaging were used to examine age-related structural changes in the brain. Older adults had reduced gray matter volume (628 ± 57 ml) and mean white matter anisotropy (0.18 ± 0.03) compared with young adults (741 ± 59 ml and 0.22 ± 0.02, respectively). Although motor performance was 53% lower in older (n = 15, mean age 63.1 years) compared with young adults (n = 15, mean age 25.5 years), motor practice improved motor performance similarly in both age groups. While executing the task, older adults showed in general greater and more widespread activation compared with young adults. BOLD activation decreased in parietal and occipital areas after skill acquisition but activation increased in these areas after consolidation in both age groups, indicating more efficient visuospatial processing immediately after skill acquisition. Changes in deactivation in specific areas were age-dependent after consolidating the motor skill into motor memory. Young adults showed greater deactivations from post-test to retention in parietal, occipital and temporal cortices whereas older adults showed smaller deactivation in the frontal cortex. Since learning rate was similar between age groups, age-related changes in activation patterns may be interpreted as a compensatory mechanism for age-related structural decline.

from Imaging via a.sfakia on Inoreader https://ift.tt/2zVw4NJ

Differentiating guilt and shame in an interpersonal context with univariate activation and multivariate pattern analyses

Publication date: Available online 12 November 2018

Source: NeuroImage

Author(s): Ruida Zhu, Chunliang Feng, Shen Zhang, Xiaoqin Mai, Chao Liu

Abstract

Guilt and shame are usually evoked during interpersonal interactions. However, no study has compared guilt and shame processing under such circumstances. In the present study, we investigated guilt and shame in an interpersonal context using functional magnetic resonance imaging (fMRI). Behaviorally, participants reported more "guilt" when their wrong advice caused a confederate's economic loss, whereas they reported more "shame" when their wrong advice were correctly refused by the confederate. The fMRI results showed that both guilt and shame activated regions related to the integration of theory of mind and self-referential information (dorsal medial prefrontal cortex, dmPFC) and to the emotional processing (anterior insula). Guilt relative to shame activated regions linked with theory of mind (supramarginal gyrus and temporo-parietal junction) and cognitive control (orbitofrontal cortex/ventrolateral prefrontal cortex and dorsolateral prefrontal cortex). Shame relative to guilt revealed no significant results. Using multivariate pattern analysis, we demonstrated that in addition to the regions found in the univariate activation analysis, the ventral anterior cingulate cortex and dmPFC could also distinguish guilt and shame. These results do not only echo previous studies of guilt and shame using recall and imagination paradigms but also provide new insights into the psychological and neural mechanisms of guilt and shame.

from Imaging via a.sfakia on Inoreader https://ift.tt/2T2wdrc