Physician self-referral for imaging and the cost of chronic care for Medicare beneficiaries.

Background: As the cost of both chronic care and diagnostic imaging continue to rise, it is important to consider methods of cost containment in these areas. Therefore, it seems important to study the relationship between self-referral for imaging and the cost of care of chronic illnesses. Previous studies, mostly of acute illnesses, have found self-referral increases utilization and, thus, probably imaging costs.

Radiology health services research: from imperative to legislative mandate.

Objective: In the era of health care reform, our value-added to patient care, its corresponding level of reimbursement, and the stature of radiology as a specialty will likely be grounded in the scientific evaluation methods of health services research.

Conclusion: We need to create more opportunities for training, provide resources and incentives for the brightest candidates to enter this field, and cultivate enriching environments for health services research in all academic radiology departments.

Rising use of CT in child visits to the emergency department in the United States, 1995-2008.

Purpose: To describe nationwide trends and factors associated with the use of computed tomography (CT) in children visiting emergency departments (EDs) in the United States between 1995 and 2008.

Materials And Methods: This study was exempt from institutional review board oversight. Data from the 1995-2008 National Hospital Ambulatory Medical Care Survey were used to evaluate the number and percentage of visits associated with CT for patients younger than 18 years.

Prolonged fasting increases glutathione biosynthesis in postweaned northern elephant seals.

Northern elephant seals experience prolonged periods of absolute food and water deprivation (fasting) while breeding, molting or weaning. The postweaning fast in elephant seals is characterized by increases in the renin-angiotensin system, expression of the oxidant-producing protein Nox4, and NADPH oxidase activity; however, these increases are not correlated with increased oxidative damage or inflammation. Glutathione (GSH) is a potent reductant and a cofactor for glutathione peroxidases (GPx), glutathione-S transferases (GST) and 1-cys peroxiredoxin (PrxVI) and thus contributes to the removal of hydroperoxides, preventing oxidative damage.

A survey of policies and procedures on the communication and documentation of radiologic interpretations.

Research into emergency medicine (EM) diagnostic errors identified imaging as a contributing factor in 94% of cases. Discrepancies between the preliminary (trainee) and the final (attending) diagnostic imaging interpretation represent a system issue that is particularly prone to creating diagnostic errors. Understanding the types of systematic communication and documentation strategies developed by academic radiology departments to address differences between preliminary and final radiology interpretations to clinicians are threshold steps toward minimizing this risk.

Hexokinase from the white shrimp Litopenaeus vannamei: cDNA sequence, structural protein model and regulation via HIF-1 in response to hypoxia.

Hexokinase (HK) catalyzes the phosphorylation of glucose, the first rate-limiting step in glycolysis. HKs are a conserved family of tissue-specific isozymes, from which very little is known in marine crustaceans. This study describes the cloning and characterization of the full-length cDNA sequence for HK from the shrimp Litopenaeus vannamei, the theoretical tridimensional protein structure and response to short-term hypoxia.

National trends in CT use in the emergency department: 1995-2007.

Purpose: To identify nationwide trends and factors associated with the use of computed tomography (CT) in the emergency department (ED).

Materials And Methods: This study was exempt from institutional review board approval. Data from the 1995-2007 National Hospital Ambulatory Medical Care Survey were used to evaluate the numbers and percentages of ED visits associated with CT.

Comparison of childhood sexual histories in subjects with pedophilia or opiate addiction and healthy controls: is childhood sexual abuse a risk factor for addictions?

Objective: Given the recent interest in the concept of sexual addictions, it is instructive to study subjects with pedophilia alongside chemically addicted individuals and non-addicted controls in order to help identify which factors may determine the objects of people's respective addictions, as well as any factors that may predispose people to developing an addictive disorder.

Method: In this study, we considered whether childhood sexual abuse (CSA) is a specific risk factor for pedophilia as opposed to other types of addictive disorders by comparing the childhood sexual histories of 48 pedophilic sex offenders, 25 subjects with opiate addiction in remission, and 61 healthy controls. CSA was assessed with The Sexual History Questionnaire and the Child Trauma Questionnaire (CTQ).

Renal ultrasonography in the evaluation of acute kidney injury: developing a risk stratification framework.

Background: In adult inpatients with acute kidney injury (AKI), clinicians routinely order a renal ultrasonography (RUS) study. It is unclear how often this test provides clinically useful information.

Methods: Cross-sectional study, including derivation and validation samples, of 997 US adults admitted to Yale-New Haven Hospital from January 2005 to May 2009, who were diagnosed as having AKI and who underwent RUS to evaluate elevated creatinine level.

An "a la carte" academic radiology compensation plan: something for everyone.

The mechanism used to compensate faculty members within academic radiology practice poses a complex challenge to radiology administrative leaders. In this article, the authors discuss a novel compensation plan model that addresses many of the demands faced by modern academic radiology practices.

The performance of outside readings by radiology practices.

Objective: The purpose of our study was to determine how many radiology practices perform outside readings, what characteristics affect the prevalence and volume of outside readings, and how practices are paid for outside readings.

Materials And Methods: We analyzed data from the American College of Radiology's 2007 Survey of Radiologists, a stratified random sample e-mail and telephone survey. A total of 480 survey responses were evaluated; responses were weighted to make them representative of all U.

Time keeping and working memory development in early adolescence: a 4-year follow-up.

In this longitudinal study, we examined time keeping in relation to working memory (WM) development. School-aged children completed two tasks of WM updating and a time monitoring task in which they indicated the passing of time every 5 min while watching a film. Children completed these tasks first when they were 8 to 12 years old and then 4 years later when they were 12 to 16 years old.

Reactive oxygen species and alpha,beta-unsaturated aldehydes as second messengers in signal transduction.

Signaling by H(2)O(2), alpha,beta-unsaturated aldehydes, such as 4-hydroxy-2-nonenal (HNE) and related chemical species, is thought to differ from signaling by other second messengers because the oxidants and other electrophiles can readily undergo nonenzymatic reactions and are therefore classified as "reactive." This brief review will describe how and when the chemistry of signaling is similar or differs from classic second messengers, such as cyclic AMP, or posttranslational signaling, such as farnesylation or ubiquitination. The chemistry of cysteine provides a common factor that underlies signaling by H(2)O(2) and HNE.

Prolonged fasting does not increase oxidative damage or inflammation in postweaned northern elephant seal pups.

Elephant seals are naturally adapted to survive up to three months of absolute food and water deprivation (fasting). Prolonged food deprivation in terrestrial mammals increases reactive oxygen species (ROS) production, oxidative damage and inflammation that can be induced by an increase in the renin-angiotensin system (RAS). To test the hypothesis that prolonged fasting in elephant seals is not associated with increased oxidative stress or inflammation, blood samples and muscle biopsies were collected from early (2-3 weeks post-weaning) and late (7-8 weeks post-weaning) fasted seals.

Reexamination of the electrophile response element sequences and context reveals a lack of consensus in gene function.

The electrophile response element (EpRE) is essential for regulation of many genes involved in protection against toxic agents. Putative EpRE core sequences (TGAnnnnGC) are localized in 5'-flanking regions (5'-UTR) of these genes but specificity of the internal bases and whether location affects function has not been refined. The catalytic subunit of human glutamate cysteine ligase (GCLC) gene is well documented to be under EpRE regulation and four sequences having an EpRE "consensus" sequence were reported with only one (EpRE 4) responsive to electrophiles.

The educational and career impact of using medical students for triaging off-hour diagnostic imaging requests at a major academic medical center.

Objective: The purpose of this article is to evaluate the educational and career impact of using medical students for triaging off-hour diagnostic imaging requests at a major academic medical center.

Subjects And Methods: A survey of former and current medical students who participated in the Emergency Department Radiology Triage Program at the Yale University School of Medicine was conducted via e-mail. Results were reported using averages or percentages or both.

C-Myc is a Nrf2-interacting protein that negatively regulates phase II genes through their electrophile responsive elements.

c-Myc is a transcription factor that is implicated in many cellular processes including proliferation, apoptosis and cancers. Recently, c-Myc was shown to be involved in regulation of glutamate cysteine ligase through E-box sequences. This investigation examined whether c-Myc also regulates phase II genes through interaction with the electrophile response element (EpRE).