Effects of Teaching Evidence-Based Medicine on Physician Assistant Students' Critical Appraisal, Self-Efficacy, and Clinical Application: A Randomized Controlled Trial.

Purpose: To use a randomized controlled design to explore the effects of evidence-based medicine (EBM) education on physician assistant (PA) students' EBM knowledge, self-efficacy, and evidence-seeking behavior in a simulated clinical situation and to present a model of EBM competence.

Methods: Sixty-one didactic-year PA students from one Midwestern University (2 sequential cohorts) were randomized to receive the standard PA curriculum plus EBM training (intervention) or the standard PA curriculum only (control). Evidence-based medicine knowledge was measured with a validated Fresno test.

Impact of primary tumor location on outcome of liposarcoma patients, a retrospective cohort study.

Background: Tumor location as a prognostic factor for patients with liposarcoma (LPS) has been studied modestly with varying outcomes. The aim was to establish the impact of tumor location on recurrence and survival of LPS patients.

Methods: A retrospective database of patients treated for LPS until December 2017 was used to assess 5-year local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS) and disease-specific survival (DSS) per tumor location using the Kaplan-Meier method and log-rank test.

Myocardial scar characteristics based on cardiac magnetic resonance imaging is associated with ventricular tachyarrhythmia in patients with ischemic cardiomyopathy.

Objectives: We hypothesized that myocardial scar characterization using cardiac magnetic resonance imaging (CMR) may be associated with the occurrence of ventricular tachyarrhythmia (VT), appropriate implantable cardioverter-defibrillator (ICD) therapy and mortality.

Background: Since a minority of patients with prophylactic ICD implantation receive appropriate ICD therapy, there is a need for more effective risk stratification for primary prevention in patients with ischemic cardiomyopathy.

Methods And Results: In 99 patients with ischemic cardiomyopathy, CMR was performed prior to ICD implantation.

Reliability of radiographic findings and the relation to etiologic agents in community-acquired pneumonia.

In a clinical setting the chest radiograph is the reference standard in establishing the diagnosis of community-acquired pneumonia (CAP). This study aimed to assess interobserver reliability (IR) of radiographic findings and the relationship to different causative pathogens in CAP. Chest radiographs of 192 patients with pneumonia, obtained from a database, were reviewed by 2 radiologists and 1 respiratory physician without specific clinical information.

[Gastrointestinal surgery and gastroenterology. XIV. Mesenteric abnormalities in generalised vascular disease].

Various forms of vasculitis may result in mesenteric ischaemia, ischaemic colitis or aneurysm formation in the aorta or intestinal blood vessels. Vasculitides may involve large- and/or medium-sized vessels, medium- and/or small-sized vessels, or small-sized vessels only. It is essential to differentiate between the different forms of vasculitis since diagnostic tests and therapies differ greatly.

Superior diagnostic strength of combined contrast enhanced MR-angiography and MR-imaging compared to intra-arterial DSA in liver transplantation candidates.

To evaluate the diagnostic value of combined contrast enhanced MRA (ce-MRA) and MRI compared to that of intra-arterial DSA (i.a.DSA) in liver transplantation, transjugular porto-systemic (TIPSS) and spleno-renal shunt candidates.

Comparison of contrast enhanced MR-angiography-MRI and digital subtraction angiography in the evaluation of pancreas and/or kidney transplantation patients: initial experience.

To evaluate whether combined contrast enhanced MRA and MRI (ce-MRA-MRI) has the potential to replace intra-arterial DSA (i.a.DSA) in patients with impaired graft function or suspected of vascular complications after pancreas and/or kidney transplantation.

Optimization of scantiming in abdominal breathhold contrast-enhanced MRA: an empirical guideline.

The objective of this study to determine a suitable scan timing scheme in contrast enhanced MRA for the depiction of the arterial, the portal and the systemic venous system in the abdomen with maximum signal intensity in healthy subjects and in patients with cirrhosis. The signal intensity in the aorta, hepatic artery, portal vein, left renal vein and the supra- and infrarenal IVC were measured in 40 consecutive orthotopic liver transplantation candidates with cirrhosis and 20 healthy renal donors in a bolus triggered arterial scan and after 30, 60, 90 and 150 s respectively. The aorta and hepatic artery showed the highest signal intensity on the arterial scan.

Arteriography and portal venography on routine follow-up after orthotopic liver transplantation.

Rationale And Objectives: To describe the findings of routinely performed angiographic examinations in patients at discharge 2 months after orthotopic liver transplantation (OLT) and at follow-up 1 year later.

Methods: The findings of 315 angiographic examinations performed in 190 patients 2 months and 1 year after OLT were reviewed, and the changes at the anastomotic site of the hepatic artery and portal vein were analyzed.

Results: Routine angiography 2 months and 1 year after OLT demonstrated a normal anastomosis or low-grade stenosis in 82% and 84% of the patients (hepatic artery) and in 88% and 84% (portal vein), respectively.

The value of Doppler ultrasound in cirrhosis and portal hypertension.

Background: Cirrhosis and portal hypertension affect the flow profile of the liver vasculature. In these conditions Doppler ultrasound can provide important information on the hemodynamics of the portal venous system, the hepatic artery and the hepatic veins.

Methods: The value of Doppler ultrasound in the assessment of the patient with cirrhosis and portal hypertension was determined by reviewing the literature.

[Giant urinoma of the thigh].

A man aged 70 during a hospital stay over a period of a few weeks developed increasing pain and swelling of the left thigh. Despite extensive diagnostic imaging and surgical drainage, initially no diagnosis could be established. After more than 3 months the tumour proved to be caused by leakage of urine from the pelvis to the soft tissues of the leg.

Chronic mesenteric ischaemia: diagnostic challenges and treatment options.

Objectives: A description of the clinical presentation, diagnostic procedure and mode of therapy in three patients suffering from chronic mesenteric ischaemia.

Design And Interventions: In all cases, the diagnosis was made on the basis of abdominal complaints in combination with angiographic findings. The primary treatment objective was restoration of blood flow via a revascularization procedure, for the patient in whom this could not be accomplished an enteral feeding programme was undertaken.

Clinical applicability of human in vivo localized phosphorus-31 magnetic resonance spectroscopy of bone and soft tissue tumors.

Background: Magnetic resonance imaging (MRI) is of restricted value for the in vivo characterization of tumor types. The applicability of phosphorus-31 (31P) magnetic resonance spectroscopy (MRS) in the diagnosis of bone and soft tissue tumors is unknown.

Methods: A total of 191 consecutive patients (85 females and 106 males; mean age 41 years, range 1-80) with a well-defined bone or soft tissue tumor on MRI were analyzed for additional 31P spectroscopy.

Patency of arm vein grafts used in aorto-coronary bypass surgery.

Arm veins have been used in myocardial revascularisation procedures as a last resort bypass conduit because of their associated low patency. Nevertheless, leg veins and mammary arteries, which are the most commonly used, are sometimes not sufficient, leaving little choice as to the bypass conduit. To assess the properties of arm veins in bypass surgery, we compared a group of 28 patients that underwent an arm vein graft coronary bypass procedure with a matched group of patients in which leg veins were used.

Intra-arterial digital subtraction angiography (DSA) as an outpatient screening method for the follow-up of graft patency in coronary surgery.

In order to determine whether intra-arterial digital subtraction angiography (= DSA) is a suitable screening method to visualise graft patency and to determine whether DSA can be performed on an outpatient basis, we studied 73 patients shortly after coronary bypass surgery. In two patients DSA was precluded due to technical problems. The patency of the grafts was adequately visualised by means of DSA in 68 of the remaining 71 patients.

Lymphoedema of the legs as a result of lymphangiomyomatosis. A case report and review of the literature.

Leg lymphoedema is described as an unusual presenting feature of lymphangiomyomatosis. MRI scanning revealed typical lesions. Possible sex hormonal manipulation as a therapy for pulmonary or abdominal involvement is reviewed.