Nonsedated Magnetic Resonance Imaging for Visualization of the Velopharynx in the Pediatric Population

2021 ◽  
pp. 105566562110573
Author(s):  
Katelyn J. Kotlarek ◽  
Thomas J. Sitzman ◽  
Jessica L. Williams ◽  
Jamie L. Perry
Keyword(s):  
Pediatric Population ◽  
Velopharyngeal Insufficiency ◽  
Limited Attention ◽  
Behavioral Adaptation ◽  
Clinical Settings ◽  
Success Rates ◽  
Resonance Imaging ◽  
Provider Training ◽  
Pediatric Mri ◽  
And Training

Background Non-sedated MRI is gaining traction in clinical settings for visualization of the velopharynx in children with velopharyngeal insufficiency. However, the behavioral adaptation and training aspects that are essential for successful pediatric MRI have received limited attention. Solution We outline a program of behavioral modifications combined with patient education and provider training that has led to high success rates for non-sedated velopharyngeal MRI in children.

scholarly journals Missing the mark: Current practices in teaching the male urogenital examination to Canadian undergraduate medical students

2016 ◽  
Vol 10 (7-8) ◽  
pp. 281
Author(s):  
Kristen McAlpine ◽  
Stephen Steele
Keyword(s):  
Medical Students ◽  
Clinical Training ◽  
Clinical Skills ◽  
Medical Schools ◽  
Clinical Settings ◽  
Undergraduate Medical Students ◽  
Canadian Medical School ◽  
Competency Based ◽  
English Speaking ◽  
And Training

<p><strong>Introduction:</strong> The urogenital physical examination is an important aspect of patient encounters in various clinical settings. Introductory clinical skills sessions are intended to provide support and alleviate students’ anxiety when learning this sensitive exam. The techniques each Canadian medical school uses to guide their students through the initial urogenital examination has not been previously reported.</p><p><strong>Methods:</strong> This study surveyed pre-clerkship clinical skills program directors at the main campus of English-speaking Canadian medical schools regarding the curriculum they use to teach the urogenital examination.</p><p><strong>Results:</strong> A response rate of 100% was achieved, providing information on resources and faculty available to students, as well as the manner in which students were evaluated. Surprisingly, over onethird of the Canadian medical schools surveyed failed to provide a setting in which students perform a urogenital examination on a patient in their pre-clinical years. Additionally, there was no formal evaluation of this skill set reported by almost 50% of Canadian medical schools prior to clinical training years.</p><p><strong>Conclusions:</strong> To ensure medical students are confident and accurate in performing a urogenital examination, it is vital they be provided the proper resources, teaching, and training. As we progress towards a competency-based curriculum, it is essential that increased focus be placed on patient encounters in undergraduate training. Further research to quantify students’ exposure to the urogenital examination during clinical years would be of interest. Without this commitment by Canadian medical schools, we are doing a disservice not only to the medical students, but also to our patient population.</p>

Delineating Toxicity Mechanisms Associated with MRI Contrast Enhancement through a Multidimensional Toxicogenomic Profiling of Gadolinium

2022 ◽  
Author(s):  
Roger M. Pallares ◽  
Dahlia D An ◽  
Solene Hebert ◽  
David Faulkner ◽  
Alex Loguinov ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Contrast Agent ◽  
Contrast Enhancement ◽  
Clinical Settings ◽  
Resonance Imaging ◽  
Mri Contrast ◽  
Toxicity Mechanisms

Although gadolinium is widely used for magnetic resonance imaging in clinical settings, many concerns regarding its toxicity and bioaccumulation after gadolinium-based contrast agent (GBCA) administration have been raised and published...

Support for staff support groups: A role for group analysts

2019 ◽  
Vol 52 (3) ◽  
pp. 339-349 ◽  
Author(s):  
Kenneth Bledin
Keyword(s):  
Support Groups ◽  
Psychology Training ◽  
Clinical Settings ◽  
Staff Support ◽  
Clinical Psychology Training ◽  
Clinical Environments ◽  
Training Courses ◽  
Training Opportunities ◽  
And Training ◽  
Quantitative Evaluations

Clinical psychologists in NHS settings are often called upon to facilitate ‘staff groups’. A survey of psychologists’ self-reported experiences of facilitating such groups indicated average levels of relevant training, moderate levels of confidence, but only average levels of effectiveness. The value and validity of quantitative evaluations of this kind are discussed. The findings suggest that more group therapies-related teaching and training are needed in clinical psychology training courses and in clinical environments in the NHS and other clinical settings. Group analysts are well placed to encourage, support and provide teaching and training opportunities such as these.

Bone Bruise and Anterior Cruciate Ligament Tears: Presence, Distribution Pattern, and Associated Lesions in the Pediatric Population

2019 ◽  
Vol 47 (13) ◽  
pp. 3181-3186
Author(s):  
Vittorio Bordoni ◽  
Giorgio di Laura Frattura ◽  
Davide Previtali ◽  
Simone Tamborini ◽  
Christian Candrian ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Cruciate Ligament ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Meniscal Lesions ◽  
Bone Bruises ◽  
Anterior Cruciate

Background: Bone bruise characteristics after anterior cruciate ligament (ACL) injury have been correlated with the level of joint derangement in adults. However, the literature lacks information about younger patients, whose higher ligamentous laxity may lead to different lesion patterns. Purpose: To investigate the prevalence, size, location, and role of bone bruise associated with ACL rupture in the pediatric population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Knee magnetic resonance imaging scans (MRIs) of patients aged 8 to 16 years with ACL tears from 2010 to 2018 were selected from the institution database. Inclusion criteria were open or partially open physes, less than 90 days between trauma and MRI, and no history of injury or surgery. Presence, localization, and size of bone bruise were analyzed by 2 blinded researchers and scored with the Whole-Organ Magnetic Resonance Imaging Score (WORMS) bone bruise subscale. Ligamentous, cartilaginous, meniscal, and other lesions were documented. Results: Of the 78 pediatric patients selected from the database, 54 (69%) had bone bruise. The mean area of bone bruise was larger in males than in females (femur, 3.8 ± 2.8 vs 2.2 ± 1.4 cm2, respectively, P = .006; tibia, 2.6 ± 1.6 vs 1.5 ± 0.8 cm2, respectively, P = .007). The subregions most affected by bone bruise were the lateral posterior tibia and the lateral central femur (in 83% and 80% of the knees affected, respectively). A low correlation was found between age and bone bruise area (biggest areas r = 0.30, P = .03, and sum of areas r = 0.27, P = .04), but no correlation was found between age and WORMS (femur, r = −0.03, P = .85; tibia, r = −0.04, P = .76). The injuries most associated with bone bruise were 23 meniscal lesions (43%), 10 lesions of other ligaments (19.0%), 2 cartilage lesions (3.7%), and 2 patellar fractures (3.7%). Conclusion: The prevalence of bone bruises in pediatric patients with ACL tears is high, although it seems slightly lower than the prevalence documented in adults but with similar localization. The area and the distribution pattern of bone bruises are similar among different ages. The pediatric patients had a lower presence of cartilage and meniscal lesions compared with that reported in adults, which suggests a different effect of this trauma on the knee of pediatric patients.

4D flow magnetic resonance imaging: role in pediatric congenital heart disease

2017 ◽  
Vol 26 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Claire M Lawley ◽  
Kathryn M Broadhouse ◽  
Fraser M Callaghan ◽  
David S Winlaw ◽  
Gemma A Figtree ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Congenital Heart Disease ◽  
Blood Flow ◽  
Heart Disease ◽  
Magnetic Resonance ◽  
Congenital Heart ◽  
Pediatric Population ◽  
Anatomical Location ◽  
Resonance Imaging ◽  
Dimensional Flow

Imaging-based evaluation of cardiac structure and function remains paramount in the diagnosis and monitoring of congenital heart disease in childhood. Accurate measurements of intra- and extracardiac hemodynamics are required to inform decision making, allowing planned timing of interventions prior to deterioration of cardiac function. Four-dimensional flow magnetic resonance imaging is a nonionizing noninvasive technology that allows accurate and reproducible delineation of blood flow at any anatomical location within the imaging volume of interest, and also permits derivation of physiological parameters such as kinetic energy and wall shear stress. Four-dimensional flow is the focus of a great deal of attention in adult medicine, however, the translation of this imaging technique into the pediatric population has been limited to date. A more broad-scaled application of 4-dimensional flow in pediatric congenital heart disease stands to increase our fundamental understanding of the cause and significance of abnormal blood flow patterns, may improve risk stratification, and inform the design and use of surgical and percutaneous correction techniques. This paper seeks to outline the application of 4-dimensional flow in the assessment and management of the pediatric population affected by congenital heart disease.

scholarly journals Determinants of managerial preventive actions in relation to common mental disorders at work

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
I W H van de Voort ◽  
A De Rijk ◽  
G Hensing ◽  
M Bertilsson
Keyword(s):  
Mental Disorders ◽  
Work Environment ◽  
Online Survey ◽  
Preventive Measures ◽  
Common Mental Disorders ◽  
Binary Logistic Regression ◽  
Limited Attention ◽  
Depression And Anxiety ◽  
Preventive Actions ◽  
And Training

Abstract Background Managers may prevent Common Mental Disorders (CMDs) among their subordinates due to their authority to influence the work environment. Yet, their perspective has received only limited attention in research. This study aims to increase managers’ capacity to contribute to the prevention of CMDs by exploring the determinants of two managerial preventive actions: ’reviewing assignments and the work situation’ (MPA-review) and ’taking initiative to talk about depression and anxiety at work’ (MPA-talk). Methods An online survey was sent to 4,737 Swedish managers, aged 20-65 years (71% participated, n = 3,358) in 2017, of which 2,921 were included as they answered the MPA-items. Ten possible determinants of MPAs, comprising person-, work-, and competence-related characteristics of managers were related to performing MPAs (yes or no). Bivariate and multivariate binary logistic regression was performed to test associations (OR with 95% CI) between each determinant and MPAs. We have adjusted for experience-related characteristics of managers and company size. Results 50% of managers initiated MPA-review and 57% MPA-talk. Managers had a higher odds to initiate respectively MPA-review and MPA-talk when being female (OR 1.42, 95% CI 1.17-1.73; OR 1.33, 95% CI 1.08-1.64), working in organizations offering lectures on CMDs (OR 1.36, 95% CI 1.01-1.83; OR 1.84, 95% CI 1.30-2.60) or stress counselling (OR 1.79, 95% 1.46-2.20; OR 1.53, 95% CI 1.22-1.91), having responsibility for the work environment (OR 1.42, 95% CI 1.15-1.74; OR 1.44, 95% CI 1.16-1.79), or having had received training on CMDs (OR 1.56, 95% CI 1.27-1.93; OR 1.61, 95% CI 1.28-2.03). Conclusions Managers report taking more actions to prevent CMDs in their workforce when they are female, have received training on CMDs or work in organisations where CMD preventive measures have been implemented. Key messages Organizations could invest in company-wide preventive measures and training to enable MPAs. Managerial education should include information on CMDs in order to improve managers’ preventive capacity.

scholarly journals Ewing's Sarcoma of the Cervical Spine

2017 ◽  
Vol 07 (02) ◽  
pp. 086-089
Author(s):  
Meenakshi Bhattacharjee ◽  
Winston Huh ◽  
Vandana Thapar ◽  
Paul Dahm
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Pediatric Population ◽  
Signs And Symptoms ◽  
Neck Mass ◽  
Neurological Deficits ◽  
Resonance Imaging ◽  
Neck Trauma ◽  
Motor Weakness ◽  
Posterior Neck

AbstractIn this article, we present the case of a 6-year-old female presented to the emergency department with progressive ascending motor weakness leading to cardiac arrest. The recent medical history included neck trauma 1 month prior to admission, 2 weeks of subjective fevers, and 1 day of urinary incontinence. After stabilization, and a review of the recent signs and symptoms, a magnetic resonance imaging of the neck revealed a posterior neck mass from C2 to T2. Neurosurgical removal of the mass was consistent with Ewing's sarcoma. Neck pain is a common presentation in the pediatric population, with the most common cause being traumatic. When coupled with neurological deficits, further studies are warranted to evaluate for organic causes.

scholarly journals Outcomes of Reapplication to Otolaryngology Residency: A Prospective Cohort Study

2018 ◽  
Vol 97 (9) ◽  
pp. 324-328
Author(s):  
Colin Fuller ◽  
J. Kenneth Byrd ◽  
Michael Groves
Keyword(s):  
Published Data ◽  
Highly Qualified ◽  
Success Rates ◽  
Residency Programs ◽  
Employment Training ◽  
Match Rate ◽  
Significant Difference ◽  
Training Activities ◽  
First Time ◽  
And Training

Although the field of otolaryngology has experienced a decline in the number of applicants to our residency programs, otolaryngology remains a highly competitive field with an extremely strong applicant pool. Many highly qualified candidates cannot obtain a position in our field each year, and many of these candidates choose to reapply the next year. Data are lacking regarding reapplicants’ success rate and the best gap year employment and training options for these reapplicants. Reapplicants were studied prospectively via a two-stage survey during the 2014–2015 and 2015–2016 application cycles. Success rates for the overall group were compared to those from published data, and success rates between subgroups were also compared. First-time reapplicants in the study performed extremely well. Their match rate (19/22) was not significantly different from that of traditional otolaryngology applicants (551/619, p = 0.73) and was significantly higher than that of nontraditional applicants not in our cohort (23/62, p < 0.001). No significant difference was found between applicants by employment/training activities, with both researchers (11/12) and surgical interns (8/10, p = 0.57) performing well. Predictors of reapplicant success could not be assessed because only 3 reapplicants in the cohort were unsuccessful. First-time otolaryngology reapplicants remain a highly competitive group of applicants to our field, regardless of employment/training activities undertaken after graduating medical school.

Sign in / Sign up

Export Citation Format

Share Document