Efficient Fuzzy Image Stretching for Automatic Ganglion Cyst Extraction Using Fuzzy C-Means Quantization

Ganglion cysts are commonly observed in association with the joints and tendons of the appendicular skeleton. Ultrasonography is the favored modality used to manage such benign tumors, but it may suffer from operator subjectivity. In the treatment phase, ultrasonography also provides guidance for aspiration and injection, and the information regarding the accurate location of the pedicle of the ganglion. Thus, in this paper, we propose an automatic ganglion cyst extracting method based on fuzzy stretching and fuzzy C-means quantization. The proposed method, with its carefully designed image-enhancement policy, successfully detects ganglion cysts in 86 out of 90 cases (95.6%) without requiring human intervention.

Trends in hospital admissions for childhood fractures in England

PurposeFractures to the axial and appendicular skeleton are common in children causing loss of opportunities and disability. There are relatively few studies available to quantify the number of children who have their fractures diagnosed in the emergency department and are then admitted to hospital for ongoing management. The purpose of this study is to explore trends of frequency, types and age of children sustaining fractures who were admitted for intervention to National Health Service (NHS) hospitals.DesignThe study uses data from the Hospital Episode Statistics and Office for National Statistics from 2012 to 2019 to calculate the annual incidence of hospital admission for limb, spine, facial and skull fractures per 100 000 children.ResultsDuring 2012–2019, 368 120 children were admitted to English NHS hospitals with a fracture. 256 008 (69.5%) were upper limb fractures, 85 737 (23.3%) were lower limb fractures and 20 939 (5.7%) were skull or facial fractures. The annual incidence of upper limb fractures was highest in children aged 5–9 (348.3 per 100 000 children) and the highest incidence of lower limb fractures was in children aged 10–15 (126.5 per 100 000 children). The incidence of skull and facial fractures in preschool (age 0–4) children has been increasing at a rate of 0.629 per 100 000 children per year.ImplicationsThe annual incidence of hospital admission for fractures in children has been shown to be consistent for several fracture types between 2012 and 2019. An increasing trend of admissions with preschool skull fractures was observed, though the study data do not have sufficient granularity to demonstrate if this is due to changes in practice or to accidental or non-accidental causes.

Deer Rescue in Tuscany: Retrospective Analysis and Assessment of Radiography Diagnoses

Animal-vehicle collisions are the major cause of rescue and need for hospitalization in wildlife referral centers. Clinicians need easy-to-use tools to make rapid decisions about whether to euthanize or treat injured animals. The aim of the study was to evaluate the data (reasons for rescue, diagnosed lesions, and outcome) from a hospitalized population of wildlife ungulates and investigate the benefits of using radiography as a diagnostic tool. Data were collected from three wildlife referral centers in Tuscany (Italy). The following information was collected for each animal: reason for hospitalization, clinical examination, radiographic examination, definitive diagnosis, and outcome. A chi-squared test was used to assess the benefits of radiography in detecting different traumatic lesions. Prevalence was reported according to the reason for hospitalization, definitive diagnosis, radiographic diagnosis, and outcome. The main reason for hospitalization was traumatic lesions due to vehicle collisions and 71.1% of the animals did not survive. Radiography was more useful in patients with traumatic axial skeletal lesions and/or multiple traumas with respect to traumatic appendicular skeleton lesions. Our results show that radiography is a useful diagnostic technique for assessing wildlife emergencies and it could help the clinician in making medical decisions.

Optimal Treatment for Patients with Oligometastatic Prostate Cancer

Oligometastatic prostate cancer (PCa) can be defined as cancer with a limited number of metastases, typically fewer than 5 lesions, and involves lesions contained within the axial versus the appendicular skeleton. Patients can present with de novo oligometastatic, oligorecurrent, or oligoprogressive PCa. Oligometastatic PCa patients demonstrate considerable improvements in survival outcomes, with a better prognosis than patients with extensive metastatic disease. However, the management of patients that present with nonsymptomatic oligometastatic PCa remains difficult. In the oligometastatic setting, the benefit of local therapies such as prostatectomy and radiotherapy on survival outcomes is an intriguing topic; however, their impact on oncological outcomes is still unknown.

Spinal cord compression with acute para-paresis due to thoracic aneurysmal bone cyst (ABC): a case report and review of the literature

Aneurysmal bone cysts (ABCs) are benign, highly vascular osseous lesions characterized by cystic, blood-filled spaces surrounded by thin perimeters of expanded bone. Children and young adults are most often affected by spinal ABCs; more than 75% of patients are younger than 20 years old at the time of presentation. Although ABCs have been documented in all areas of the axial and appendicular skeleton, ABCs of the spine present unique challenges due to the risk of vertebral destabilization, pathological fracture, and vertebral body (VB) collapse with neurological compromise. We describe here a case of a 12-year-old child who presented with cervical pain and gait disturbances starting a few weeks prior to his admission with acute paraparesis at the time of admission. Subsequently he was found to have a Thoracic ABC involving T1-T3.This was accompanied by T2 vertebral body collapse and spinal cord compression. He was investigated and treated promptly by resection of the aneurysmal bone cyst with posterior Cervical-thoracic instrumentation. There was full post-operative neurological resolution.