Inadequate deltoid muscle penetration and concerns of improper COVID mRNA vaccine administration can be avoided by injection technique modification.

Background: Recent phase-3 clinical trials have demonstrated very encouraging results for mRNA based vaccines against COVID-19. Current FDA and manufacturer guidelines mandate intramuscular administration of these vaccines, as other administration routes may not provide the same levels of effectiveness and safety. Observing the vast amount of published media images of persons receiving their vaccines, the authors noted in many cases the injection technique involved skin bunching, raising concerns of inadequate deltoid muscle penetration and consequent lowered vaccine efficacy.

Chylous ascites as a late complication of one anastomosis gastric bypass-minigastric bypass: case report.

Background: One anastomosis gastric bypass- minigastric bypass (OAGB-MGB) is an emerging bariatric surgery that is being endorsed by surgeons worldwide. Internal herniation is a rare and dreaded complication after malabsorptive bariatric procedures, which necessitates early diagnosis and intervention.

Case Presentation: We describe a 29-year-old male with chylous ascites caused by an internal hernia 8 months following laparoscopic one anastomosis gastric bypass.

[4-dimensional computed tomography for localization of parathyroid adenoma].

Introduction: In about 85% of patients with primary hyperparathyroidism (pHPT) only a single parathyroid gland is diseased. The operation of choice in this group of patients is minimally invasive parathyroidectomy (MIP). In order to perform an MIP, the diseased gland should be identified prior to surgery.

Ganglioneuroma of the adrenal gland: a rare tumor in a rare location.

A 62-year-old man presented to his general practitioner complaining of non-specific back pain. He underwent a computerized tomography scan and magnetic resonance imaging that revealed a large left adrenal mass. A thorough investigation of this mass revealed it to be a non-secreting tumor.

Color-coded duplex sonography compared to multidetector computed tomography for the diagnosis of crohn disease relapse and complications.

Objectives: The purpose of this study was to evaluate the accuracy of color-coded duplex sonography for the diagnosis of Crohn disease relapse and complications compared to multidetector computed tomography (CT).

Methods: The Institutional Ethics Committee approved the protocol research, and written consent forms were obtained. Patients with a diagnosis of Crohn disease presenting with symptoms of relapse or complications (54 patients; 27 female; ages 9-80 years; mean, 34.

Optimizing management of pancreatic cysts--prospective re-assessment for 157 cases.

Background/aims: Ongoing debate continues regarding the appropriate management of pancreatic cysts (PCs). Disagreement prevails regarding frequency of needed follow-up, if and when to perform any PC needle biopsy and indications for surgical resection. EUS is increasingly used to help determine management of PCs.

Coping with war mass casualties in a hospital under fire: the radiology experience.

Objective: We report the role of the imaging department at a level 1 trauma center during the Second Lebanon War (summer 2006). Our institution received 849 military and civilian casualties, an average of 25 war-injured patients per day, 338 with acute traumatic stress disorders and 511 physically injured, coming in waves after a rocket attack or a battle confrontation. About 12 potentially critical physically injured patients per day were referred to the imaging department for sometimes complex imaging procedures.

Pseudopancreatitis in trauma patients.

Objective: The purpose of our study was to review the significance of intra- and peripancreatic fluid in trauma patients who have no other signs of pancreatic injury.

Conclusion: We propose that intra- and peripancreatic fluid may be the consequence of hypovolemic shock treated with hyperhydration when there is significant delay between injury and imaging.

Diagnosing acute appendicitis in adults: accuracy of color Doppler sonography and MDCT compared with surgery and clinical follow-up.

Objective: The objective of our study was to evaluate the accuracy of color Doppler sonography and contrast-enhanced MDCT in the diagnosis of acute appendicitis in adults and their utility as a triage tool in lower abdominal pain.

Materials And Methods: We reviewed the medical records of 420 consecutive adult patients, 271 women and 149 men, 18 years old or older, referred from the emergency department to sonography examination for clinically suspected acute appendicitis between January 2003 and June 2006. Patients underwent sonography of the right upper abdomen and pelvis followed by graded compression and color Doppler sonography of the right lower quadrant.

FDG avidity and PET/CT patterns in primary gastric lymphoma.

Purpose: The use of 18F-fluoro-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in primary gastric lymphoma (PGL) is challenging due to physiologic FDG activity in the stomach and variability in the degree of uptake in various histologic subtypes. This study assesses FDG avidity and PET/CT patterns in newly diagnosed PGL.

Methods: Sixty-two PET/CT studies of newly diagnosed PGL were reviewed (24 low-grade mucosa-associated lymphoid tissue [MALT], 38 aggressive non-Hodgkin's lymphoma [AGNHL]).

Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy.

Background: Capsule endoscopy (CE) of the small bowel has become a standard diagnostic tool, but there have been concerns regarding the risk of capsule retention in certain high-risk groups. The Agile patency system, an ingestible and dissolvable capsule with an external scanner, was developed to allow physicians to perform CE with greater confidence that the capsule will be safely excreted in patients at risk for capsule retention.

Objective: Our purpose was to assess the ability of the device to help physicians identify which patients with known strictures may safely undergo CE.

The utility of focused assessment with sonography for trauma as a triage tool in multiple-casualty incidents during the second Lebanon war.

Objective: The purpose of this study was to evaluate the role of focused assessment with sonography for trauma (FAST) as a triage tool in multiple-casualty incidents (MCIs) for a single international conflict.

Methods: The charts of 849 casualties that arrived at our level 1 trauma referral center were reviewed. Casualties were initially triaged according to the Injury Severity Score at the emergency department gate.

Focused helical CT using rectal contrast material only as the preferred technique for the diagnosis of suspected acute appendicitis: a prospective, randomized, controlled study comparing three different techniques.

Purpose: Focused helical CT using rectal contrast material only has emerged recently as an accurate diagnostic tool for the evaluation of suspected acute appendicitis. This study was designed to prospectively compare the efficacy of rectal contrast CT to other commonly used contrast-enhanced and nonenhanced CT techniques for the detection of acute appendicitis.

Methods: A total of 232 patients with clinically suspected appendicitis were randomly assigned to one of three focused helical CT techniques: noncontrast enhanced CT, CT using rectal contrast material only, and dual-contrast CT using both oral and intravenous material.

Acute cytomegalovirus infection associated with the onset of inflammatory bowel disease.

A 29-year-old man was admitted with high-grade fever, crampy abdominal pain, and watery diarrhea that had persisted for 2 weeks before his admission. Symptomatic treatment (acetaminophen only) was of no benefit. On physical examination, there was diffuse abdominal tenderness.

Esophageal varices: evaluation with esophagography with barium versus endoscopic gastroduodenoscopy in patients with compensated cirrhosis--blinded prospective study.

Purpose: To prospectively evaluate the accuracy of esophagography with barium in diagnosis of esophageal varices (EV) in patients with compensated cirrhosis, with endoscopic gastroduodenoscopy as the reference standard.

Materials And Methods: In this study, which was approved by the local Helsinki Committee and in which all patients consented to participate, 61 patients with cirrhosis (34 men, 27 women; mean age, 61 years; range, 36-76 years) received a diagnosis clinically or with liver biopsy. In 87% (n = 53) of patients, Child-Pugh classification was A; in 13% (n = 8), Child-Pugh classification was B.

PET/CT detection of unexpected gastrointestinal foci of 18F-FDG uptake: incidence, localization patterns, and clinical significance.

Unlabelled: Precise PET/CT localization of focal (18)F-FDG uptake in the gastrointestinal tract (GIT) may exclude malignancy in sites of physiologic activity but may also induce false-negative reports for malignant or premalignant lesions. The purpose of the present study was to retrospectively evaluate the nature and significance of unexpected focal (18)F-FDG uptake localized by PET/CT within the GIT.

Methods: The files of 4,390 patients referred for (18)F-FDG PET/CT were retrospectively reviewed.

Pericardiocentesis ending in the superior vena cava.

Pericardiocentesis is associated with a wide range of complications. We describe a pericardiocentesis attempt ending in the superior vena cava through the route of liver parenchyma, hepatic vein, inferior vena cava, and right atrium.

Retroperitoneal hematoma after spinal anesthesia with the paramedian approach.

Unlabelled: We present a case of a patient who developed a retroperitoneal bleeding after spinal anesthesia using 22-gauge Quincke needle, with the paramedian approach. Two attempts were needed to accomplish the block. Four hours later the patient complained of back pain radiating to her left calf, with weakness of the quadriceps muscle.

Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn's disease.

Background: The recently introduced wireless M2A capsule video endoscopy (CVE) has been demonstrated to be superior to barium follow-through and enteroscopy in diagnosing patients with occult blood loss and iron-deficiency anaemia.

Objective: To further investigate CVE in comparison to barium follow-through and entero-computerized tomography (CT) in establishing the diagnosis of patients with suspected Crohn's disease.

Design And Setting: The study was conducted in one academic hospital.

Multidetector CT angiography of peripheral vascular disease: a prospective comparison with intraarterial digital subtraction angiography.

Objective: The purpose of this study was to determine the accuracy of CT angiography using a multidetector scanner in the evaluation of patients with peripheral vascular disease.

Subjects And Methods: Eighteen patients with peripheral vascular disease who were referred for elective digital subtraction angiography (DSA) also underwent CT angiography. We scanned patients from the level of the superior mesenteric artery to the pedal arteries in a single helical scan.