scholarly journals Current Standards for and Clinical Impact of Emergency Radiology in Major Trauma

2022 ◽  
Vol 19 (1) ◽  
pp. 539
Author(s):  
Francesca Iacobellis ◽  
Ahmad Abu-Omar ◽  
Paola Crivelli ◽  
Michele Galluzzo ◽  
Roberta Danzi ◽  
...  
Keyword(s):  
Imaging Techniques ◽  
Trauma Team ◽  
High Energy ◽  
Nonoperative Treatment ◽  
Vascular Injuries ◽  
Industrialized Countries ◽  
Traumatic Injuries ◽  
Ct Protocol ◽  
Causes Of Mortality ◽  
Neurological Injuries

In industrialized countries, high energy trauma represents the leading cause of death and disability among people under 35 years of age. The two leading causes of mortality are neurological injuries and bleeding. Clinical evaluation is often unreliable in determining if, when and where injuries should be treated. Traditionally, surgery was the mainstay for assessment of injuries but advances in imaging techniques, particularly in computed tomography (CT), have contributed in progressively changing the classic clinical paradigm for major traumas, better defining the indications for surgery. Actually, the vast majority of traumas are now treated nonoperatively with a significant reduction in morbidity and mortality compared to the past. In this sense, another crucial point is the advent of interventional radiology (IR) in the treatment of vascular injuries after blunt trauma. IR enables the most effective nonoperative treatment of all vascular injuries. Indications for IR depend on the CT evidence of vascular injuries and, therefore, a robust CT protocol and the radiologist’s expertise are crucial. Emergency and IR radiologists form an integral part of the trauma team and are crucial for tailored management of traumatic injuries.

Thumb Injuries and Instabilities. Part 2: Spectrum of Lesions

2021 ◽  
Vol 25 (02) ◽  
pp. 355-365
Author(s):  
Alain G. Blum ◽  
Marnix T. van Holsbeeck ◽  
Stefano Bianchi
Keyword(s):  
Soft Tissues ◽  
Imaging Techniques ◽  
Metacarpophalangeal Joint ◽  
Resonance Imaging ◽  
Ligament Injuries ◽  
First Line ◽  
Collateral Ligament ◽  
Traumatic Injuries ◽  
Line Imaging

AbstractThe motor function of the thumb and its alignment with regard to the hand make it particularly vulnerable to trauma. Pathology encountered in this joint is varied, and imaging techniques play a crucial role in the diagnosis and characterization of injury. Despite advances in imaging technology, acute thumb injuries remain a challenge for radiologists. Currently, standard radiography and ultrasonography are frequently used first-line imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations. Magnetic resonance imaging may be used to optimally characterize soft tissues and bone marrow. In this article, we cover the most common traumatic injuries: fractures, dislocations, collateral ligament injuries of the metacarpophalangeal joint, as well as soft tissue lesions.

scholarly journals Focal changes in brain energy and phospholipid metabolism in first-episode schizophrenia

2004 ◽  
Vol 184 (5) ◽  
pp. 409-415 ◽  
Author(s):  
J. Eric Jensen ◽  
Jodi Miller ◽  
Peter C. Williamson ◽  
Richard W J. Neufeld ◽  
Ravi S. Menon ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Imaging Techniques ◽  
High Energy ◽  
Brain Regions ◽  
Anterior Cingulate ◽  
First Episode ◽  
Resonance Spectroscopy ◽  
Membrane Breakdown ◽  
First Episode Schizophrenia

BackgroundMembrane phospholipid and high-energy abnormalities measured with phosphorus magnetic resonance spectroscopy (31P-MRS) have been reported in patients with schizophrenia in several brain regions.AimsUsing improved imaging techniques, previously inaccessible brain regions were examined in patients with first-episode schizophrenia and healthy volunteers with 4.0 T 31P-MRS.MethodBrain spectra were collected in vivo from 15 patients with first-episode schizophrenia and 15 healthy volunteers from 15 cm3 effective voxels in the thalamus, cerebellum, hippocampus, anterior/posterior cingulate, prefrontal cortex and parieto-occipital cortex.ResultsPeople with first-episode schizophrenia showed increased levels of glycerophosphocholine in the anterior cingulate. Inorganic phosphate, phosphocreatine and adenosine triphosphate concentrations were also increased in the anterior cingulate in this group.ConclusionsThe increased phosphodiester and high-energy phosphate levels in the anterior cingulate of brains of people with first-episode schizophrenia may indicate neural overactivity in this region during the early stages of the illness, resulting in increased excitotoxic neural membrane breakdown.

scholarly journals The Structure of the Causes of Primary Prosthetics of the Shoulder Joint

2021 ◽  
pp. 42-48
Author(s):  
S.S. Strafun ◽  
I.S. Zanko
Keyword(s):  
Shoulder Joint ◽  
General Structure ◽  
High Energy ◽  
Acute Injury ◽  
Clinical Group ◽  
Aseptic Necrosis ◽  
Traumatic Injuries ◽  
Female Patients ◽  
Number Of Patients ◽  
Post Traumatic

Relevance. Shoulder prosthetics is the method of choice in the treatment of patients with traumatic injuries that significantly impair joint function and are accompanied by prolonged pain. Objective: to investigate the main causes of injuries of the shoulder joint that led to its prosthetics. Materials and Methods. The clinical group consisted of 162 patients who underwent shoulder prosthetics in the Department of Microsurgery and Reconstructive Surgery of the Upper Limb of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”. There were 44.4% male and 55.5% female patients. The average age of male patients was 62±11.4 years; the average age of female patients was 66±10.1 years. The average period of seeking specialized medical care after an acute injury was 24±10.9 days and 50.6±81.1 months in patients with post-traumatic consequences. In most cases, patients underwent unipolar prosthetics of the shoulder joint (126 patients, 78.7%); 27 patients (15.6%) underwent reversible prosthetics and 9 (5.6%) – total prosthetics, respectively. Results. In most cases, shoulder prosthetics were performed in patients with acute (up to 3 weeks from the date of injury) and old fractures and fractures of the proximal epimetaphysis of the humerus – 35 (21.6%) and 48 (29.6%) patients, respectively. The number of patients with posttraumatic aseptic necrosis of the humeral head was 49 (30.2%) (p<0.005), which indicates a high frequency of complications after osteosynthesis etc. The number of patients with massive traumatic injuries of the tendons of the rotator cuff who needed shoulder prosthetics was 18 (11.1%) and with false joints – 12 (7.4%). Unipolar prosthesis systems predominated in the general structure of the prosthesis type (126 patients, 78.7%), since reversible and total prosthesis in Ukraine were registered not so long ago. Conclusions. The analysis of our observations showed that the causes of shoulder prosthetics are severe injuries that occur with high-energy injuries (101 patients, 62.3%) and post-traumatic aseptic necrosis (49 patients, 30.2%). Acute and old fractures and fractures of the proximal metaepiphysis of the humerus are one of the most common injuries according to the analysis (35 patients, 21.6% and 48 patients, 29.6%), and their number and complexity continues to increase with age. Understanding the etiological factors that led to shoulder endoprosthetics makes it possible to predict long-term functional results and work to reduce the number of such patients.

The additional value of the arterial phase in the CT assessment of liver vascular injuries after high-energy blunt trauma

2019 ◽  
Vol 26 (6) ◽  
pp. 647-654 ◽  
Author(s):  
Francesca Iacobellis ◽  
Mariano Scaglione ◽  
Antonio Brillantino ◽  
Maria Giuseppina Scuderi ◽  
Francesco Giurazza ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
High Energy ◽  
Arterial Phase ◽  
Vascular Injuries ◽  
Additional Value

scholarly journals Traumatic infra-renal aortic dissection after a high-energy trauma: a case report of a primary missed diagnosis

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Holger Godry ◽  
Guido Rölleke ◽  
Achim Mumme ◽  
Thomas A. Schildhauer ◽  
Martin Gothner
Keyword(s):  
Aortic Dissection ◽  
Ct Scan ◽  
High Energy ◽  
The Body ◽  
Trauma Patients ◽  
Traumatic Injuries ◽  
High Energy Trauma ◽  
Missed Injuries ◽  
Lumbar Vertebral Body ◽  
Life Threatening

A traumatic infra-renal aortic dissection is a rare but life-threatening injury that follows deceleration injuries. The mechanism of blunt abdominal aortic injury involves both direct and indirect forces. The successful management of patients with traumatic injuries depends on a prompt suspicion of the injury and early diagnosis and therapy. Missed injuries in trauma patients are well-described phenomena and implementation of the ATLS® trauma schedule led to a decrease in the number of missed injuries, but trauma computed tomography (CT) scans in injured patients are still not standard. We report on a 54-year old Caucasian female patient who was involved in a car accident. The fellow passenger of the car was seriously injured. The patient had been previously treated at two different hospitals, and a dislocated acetabular fracture had been diagnosed. Because of this injury, the patient was transferred to our institution, a level 1 trauma-center where, according to the nature of the accident as a high-energy trauma, a complete polytrauma management was performed at the time of admission. During the body check, a moderate tension of the lower parts of the abdomen was detected. During the CT scan, an aneurysm of the infra-renal aorta with a dissection from the height of the second lumbar vertebral body to the iliac artery was observed. The patient required an operation on the day of admission. After 19 days post-trauma care the patient was able to leave our hospital in good general condition. Therefore, missed injuries in multiple injury patients could be fatal, and it is essential that the orthopedic surgeon leaves room for suspicion of injuries based on the nature of the trauma. Traumatic injuries of the abdominal aorta are rare. According to the ATLS® trauma schedule, all of the patients who have experienced high-energy trauma and associated fractures should undergo routine screening using a trauma CT scan with contrast agents to detect potential life-threatening injuries. In case of abdominal trauma, an aortic dissection, which can easily be overlooked, has to be considered.

scholarly journals High-resolution spectral imaging of SNR W44 and IC443 at 22 GHz with the Sardinia Radio Telescope

2017 ◽  
Vol 12 (S331) ◽  
pp. 190-193
Author(s):  
S. Loru ◽  
A. Pellizzoni ◽  
E. Egron ◽  
N. Iacolina ◽  
S. Righini ◽  
...  
Keyword(s):  
High Resolution ◽  
Radio Telescope ◽  
High Frequency ◽  
Electron Distribution ◽  
Ad Hoc ◽  
Imaging Techniques ◽  
High Energy ◽  
Spatially Resolved ◽  
High Energy Tail ◽  
Science Activities

AbstractIn the framework of the Astronomical Validation and Early Science activities of the Sardinia Radio Telescope (SRT, www.srt.inaf.it), we performed 22 GHz imaging observations of SNR W44 and IC443. Thanks to the single-dish imaging performances of SRT and innovative ad hoc imaging techniques, we obtained maps that provide a detailed view of the structure of the remnants. We are planning to exploit the high-frequency radio data of SNRs to better characterize the spatially-resolved spectra and search for possible spectral steepening or breaks in selected SNR regions, assessing the high-energy tail of the region-dependent electron distribution.

scholarly journals A Novel Closed-Chest Porcine Model of Chronic Ischemic Heart Failure Suitable for Experimental Research in Cardiovascular Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Giuseppe Biondi-Zoccai ◽  
Elena De Falco ◽  
Mariangela Peruzzi ◽  
Elena Cavarretta ◽  
Massimo Mancone ◽  
...  
Keyword(s):  
Heart Failure ◽  
Industrialized Countries ◽  
Chronic Ischemia ◽  
Mortality And Morbidity ◽  
Closed Chest ◽  
Permanent Occlusion ◽  
Causes Of Mortality ◽  
Chronic Ischemic Heart Failure ◽  
The Many ◽  
Large Animals

Cardiac pathologies are among the leading causes of mortality and morbidity in industrialized countries, with myocardial infarction (MI) representing one of the major conditions leading to heart failure (HF). Hitherto, the development of consistent, stable, and reproducible models of closed-chest MI in large animals, meeting the clinical realism of a patient with HF subsequent to chronic ischemic necrosis, has not been successful. We hereby report the design and ensuing application of a novel porcine experimental model of closed-chest chronic ischemia suitable for biomedical research, mimicking post-MI HF. We also emphasize the key procedural steps involved in replicating this unprecedented model, from femoral artery and vein catheterization to MI induction by permanent occlusion of the left anterior descending coronary artery through superselective deployment of platinum-nylon coils, as well as endomyocardial biopsy sampling for histologic analysis and cell harvesting. Our model could indeed represent a valuable contribution and tool for translational research, providing precious insights to understand and overcome the many hurdles concerning, and currently quenching, the preclinical steps mandatory for the clinical translation of new cardiovascular technologies for personalized HF treatments.

scholarly journals Ghost imaging with electron microscopy inspired, non-orthogonal phase masks

2021 ◽  
Author(s):  
Akhil Kallepalli ◽  
Daan Stellinga ◽  
Ming-Jie Sun ◽  
Richard Bowman ◽  
Enzo Rotunno ◽  
...  
Keyword(s):  
High Resolution ◽  
Imaging Techniques ◽  
High Energy ◽  
Reconstruction Method ◽  
Ghost Imaging ◽  
Light Modulator ◽  
Transmission Electron ◽  
Resolution Imaging ◽  
Electron Microscopes ◽  
Energy Processes

Abstract Transmission electron microscopes (TEM) achieve high resolution imaging by raster scanning a focused beam of electrons over the sample and measuring the transmission to form an image. While a TEM can achieve a much higher resolution than optical microscopes, they face challenges of damage to samples during the high energy processes involved. Here, we explore the possibility of applying computational ghost imaging techniques adapted from the optical regime to reduce the total, required illumination intensity. The technological lack of the equivalent high-resolution, optical spatial light modulator for electrons means that a different approach needs to be pursued. Using the optical equivalent, we show that a simple six-needle charged device to modulate the illuminating beam, alongside a novel reconstruction method to handle the resulting highly non-orthogonal patterns, is capable of producing images comparable in quality to a raster-scanned approach with much lower peak intensity.

scholarly journals Effect of Early Pelvic Binder Use in Emergency Management of Suspected Pelvic Trauma: A Retrospective Cohort Study

2017 ◽  
Author(s):  
Sheng-Der Hsu ◽  
Cheng-Jueng Chen ◽  
Yu-Ching Chou ◽  
Sheng-Hao Wang ◽  
De-Chuan Chan
Keyword(s):  
Cervical Spine ◽  
Emergency Management ◽  
Injury Severity ◽  
Trauma Team ◽  
High Energy ◽  
Pelvic Trauma ◽  
Pelvic Injury ◽  
Trauma Patients ◽  
Pelvic Binder ◽  
Trauma Score

Background: We aimed to evaluate the effect of early pelvic binder use in emergency management of suspected pelvic trauma, compared with the conventional stepwise approach. Methods: We enrolled trauma patients with initial stabilization using a pelvic binder for suspecting pelvic injury. Inclusion criteria were traumatic injury requiring a trauma team and at least one of the following: loss of consciousness or Glasgow coma score (GCS) &lt; 13; systolic blood pressure &lt; 90 mmHg; falling from &ge;6 m; injury to multiple vital organs; and suspected pelvic injury. Various parameters, including gender, age, mechanism of injury, GCS, mortality, hospital stay, initial vital sign, revised trauma score, injury severity score, and outcome, were assessed and compared with historical controls. Results: A total of 204 patients with high-energy multiple-trauma from single level I trauma center in North Taiwan were enrolled in the study from August 2013 to July 2014. The two group baseline patient characteristics were all collected and compared. The trauma patients with suspected pelvic fractures initially stabilized with a pelvic binder had shorter hospital and ICU stays. The study group achieved statistically significantly improved survival and lower mean blood transfusion volume and mortality rate although they were more severe in the trauma score. Conclusions: We recommend prompt pelvic binder use for suspected pelvic injury before definitive imaging is available, as a cervical spine collar is used to protect the cervical spine from further injury prior to definitive identification and characterization of an injury.

Major Trauma (DRAFT)

2018 ◽  
Author(s):  
Patrick R. Varley ◽  
Louis H. Alarcon
Keyword(s):  
United States ◽  
Cause Of Death ◽  
Major Trauma ◽  
Trauma Team ◽  
The United States ◽  
Equipment And Supplies ◽  
Traumatic Injuries ◽  
The Past ◽  
Trauma Teams ◽  
Injured Patients

Trauma is a leading cause of death and disability in the United States. Although it is generally considered to occur mostly outside of the hospital, traumatic injuries may occur anywhere. Outcomes for patients experiencing major trauma are closely linked to the healthcare response. Appropriate responses to traumatic injuries have been developed over the past 50 years, and are now considered to involve the care of a well-trained trauma team. This team utilizes established protocols to rapidly evaluate and treat injured patients. This chapter discusses the evolution of trauma teams, equipment and supplies, and the primary, secondary, and tertiary surveys used in trauma team response.

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