Dose monitoring in pediatric and young adult head and cervical spine CT studies at two emergency duty departments

Acute cervical facet fractures are increasingly being detected due to the use of cervical spine CT imaging in the initial assessment of trauma patients. For displaced cervical facet fractures with dislocations and subluxations, early surgery can decompress the spinal cord and stabilize the spine. For patients with non-displaced cervical facet fractures, the challenge in managing these patients is the determination of spinal stability. Although many of the patients with non-displaced cervical facet fractures can be managed with a cervical collar, the imaging needs to be analyzed carefully since certain fracture patterns may be better managed with early surgical stabilization.

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Can emergency physicians accurately rule out clinically important cervical spine injuries by using computed tomography?

CJEM ◽

10.2310/8000.2013.130978 ◽

2014 ◽

Vol 16 (02) ◽

pp. 131-135 ◽

Cited By ~ 3

Author(s):

Hendrik P. Van Zyl ◽

James Bilbey ◽

Alan Vukusic ◽

Todd Ring ◽

Jennifer Oakes ◽

...

Keyword(s):

Cervical Spine ◽

Cervical Spine Injury ◽

Clinical Skills ◽

Ct Scans ◽

Spine Injury ◽

Emergency Physicians ◽

Cervical Spine Injuries ◽

Spine Ct ◽

Spine Injuries ◽

Rule Out

ABSTRACT Objective: Emergency physicians are expected to rule out clinically important cervical spine injuries using clinical skills and imaging. Our objective was to determine whether emergency physicians could accurately rule out clinically important cervical spine injuries using computed tomographic (CT) imaging of the cervical spine. Method: Fifteen emergency physicians were enrolled to interpret a sample of 50 cervical spine CT scans in a nonclinical setting. The sample contained a 30% incidence of cervical spine injury. After a 2-hour review session, the participants interpreted the CT scans and categorized them into either a suspected cervical spine injury or no cervical spine injury. Participants were asked to specify the location and type of injury. The gold standard interpretation was the combined opinion of two staff radiologists. Results: Emergency physicians correctly identified 182 of the 210 abnormal cases with cervical spine injury. The sensitivity of emergency physicians was 87% (95% confidence interval [CI] 82–91), and the specificity was 76% (95% CI 74–77). The negative likelihood ratio was 0.18 (95% CI 0.12–0.25). Conclusion: Experienced emergency physicians successfully identified a large proportion of cervical spine injuries on CT; however, they were not sufficiently sensitive to accurately exclude clinically important injuries. Emergency physicians should rely on a radiologist review of cervical spine CT scans prior to discontinuing cervical spine precautions.

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CT for all or selective approach? Who really needs a cervical spine CT after blunt trauma

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0b013e31827e2acc ◽

2013 ◽

Vol 74 (4) ◽

pp. 1098-1101 ◽

Cited By ~ 16

Author(s):

Therèse M. Duane ◽

Andrew Young ◽

Julie Mayglothling ◽

Sean P. Wilson ◽

William F. Weber ◽

...

Keyword(s):

Cervical Spine ◽

Blunt Trauma ◽

Selective Approach ◽

Spine Ct

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Screening cervical spine MRI after normal cervical spine CT scans in patients in whom cervical spine injury cannot be excluded by physical examination

The American Journal of Surgery ◽

10.1016/j.amjsurg.2008.07.040 ◽

2008 ◽

Vol 196 (6) ◽

pp. 857-863 ◽

Cited By ~ 21

Author(s):

Megan Steigelman ◽

Peter Lopez ◽

Daniel Dent ◽

John Myers ◽

Michael Corneille ◽

...

Keyword(s):

Cervical Spine ◽

Physical Examination ◽

Cervical Spine Injury ◽

Ct Scans ◽

Spine Injury ◽

Spine Ct ◽

Spine Mri

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Gouty Arthropathy of the Cervical Spine in a Young Adult

Journal of the Chinese Medical Association ◽

10.1016/s1726-4901(09)70354-5 ◽

2007 ◽

Vol 70 (4) ◽

pp. 180-182 ◽

Cited By ~ 12

Author(s):

Yi-Jie Kuo ◽

Chang-Jung Chiang ◽

Yang-Hwei Tsuang

Keyword(s):

Cervical Spine ◽

Young Adult

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Comparative analysis of the promixate compositions of Tarpon atlanticus and Clarias gariepinus from culture systems in south-western Nigeria

African Journal of Food, Agriculture, Nutrition and Development ◽

10.18697/ajfand.47.9845 ◽

2011 ◽

Vol 11 (47) ◽

pp. 5344-5359

Author(s):

Emmanuel BE ◽

◽

C Oshionebo ◽

NF Aladetohun ◽

Keyword(s):

Comparative Analysis ◽

Young Adult ◽

Protein Content ◽

Proximate Composition ◽

High Protein ◽

High Protein Content ◽

Culture Systems ◽

Total Length ◽

Significant Difference ◽

Adult Head

The comparative analysis of the proximate compositions of Tarpon atlanticus (megalops) and Clariasgariepinus (African catfish) collected from two culture systems (Pen and concrete pond) were examined . Parameters of proximate composition analysed were moisture, ash, protein, fibre, fat and carbohydrate from the head and tail region. Proximate composition comparison was also done with various sizes of the two species of fish which are the juvenile, young adult and a dult forms . The total length and weight of juvenile ranged from 24.5 - 26.5cm, 178.3 - 180g and 25.2 - 27.4cm, 177.6 - 179.5g for T. atlanticus and C. gariepinus , respectively. For the young adult, the total length and weight ranged from 27.0 - 28.5cm, 212 .0 - 220.1g and 26.9 - 29.4cm, 214.2 - 221.3g for T. atlanticus and C. gariepinus , respectively. For the adults, the total length and weight ranged from 40.20 - 42.10cm, 783 - 800g and 39.9 - 44.5cm, 785 - 805g for T. atlanticus and C. gariepinus , respectively . Analysis of variance (ANOVA) showed no significant difference (P<0.05) between the moisture content of T. atlanticus and C. gariepinus in the adult head although there was a significant difference (P<0.01) between the ash of T. atlanticus and C. gariepinus in the adult tail. There was no significant difference (P<0.05) between the protein of T. atlanticus and C. gariepinus in the young adult tail but there was a significant difference (p<0.05) between the fibre of T. atlanticus and C. gariepinus in the juve nile tail. There was a significant difference (p<0.01) between the fat and oil of T. atlanticus and C. gariepinus . Ash content was highest in the adult head of T. atlanticus and lowest in the adult tail of C. gariepinus . Protein was at its highest in the young adult tail of C. gariepinus and lowest in the juvenile head of T. atlanticus . The low concentration of lipids in the muscles of these species could be due to poor storage mechanism s and the use of fat reserves during spawning activities. Generally the two species contain high protein content as f ou nd out in this study. The high tissue protein content may have resulted from high protein content of their diets. Thus , both fish species constitute a high source of protein and low fatty acids, as well as an ideal dietetic fish food for human consumption.

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