Feasibility of wide detector three-pass arterial phase liver CT in patients with cirrhosis: timing of hyperenhancing lesion peak conspicuity.

Purpose: To evaluate feasibility of a wide detector liver CT protocol with three acquisitions in the hepatic arterial phase.

Methods: Forty-one patients with cirrhosis prospectively underwent a wide detector axial liver CT protocol. Three 16 cm axial liver acquisitions were obtained during a single breath hold at peak aortic enhancement plus 10, 20, and 25 s.

Dual-Energy CT Urography With 50% Reduced Iodine Dose Versus Single-Energy CT Urography With Standard Iodine Dose.

Objective: The purpose of this study was to compare dual-energy CT (DECT) urography with a 50% reduced iodine dose to single-energy CT (SECT) urography with a standard iodine dose with respect to attenuation of renal vascular and urinary tract structures and with respect to image quality.

Subjects And Methods: The study included 62 patients undergoing evaluation of urinary tract lithiasis, tumor, or hematuria. Thirty-one patients underwent DECT urography with a 50% reduced iodine dose and reconstruction at 50 and 77 keV.

Prospective comparison of dual-energy CT aortography using 70% reduced iodine dose versus single-energy CT aortography using standard iodine dose in the same patient.

Purpose: To compare dual-energy computed tomography (DECT) aortography using a 70% reduced iodine dose to single-energy CT (SECT) aortography using a standard iodine dose in the same patient.

Methods: Twenty-one patients with a prior SECT aortography using standard iodine dose had DECT aortography using 70% reduced iodine dose. Section 120 kVp images were compared to DECT images reconstructed at both 50 and 77 keV.

Wide-detector axial CT versus 4 cm detector helical CT for transcatheter aortic valve replacement: iodine dose, radiation, and image quality.

Purpose: This study aims to compare transcatheter aortic valve replacement (TAVR) planning on 16 cm wide-detector computed tomography (CT) to TAVR planning on 4 cm detector CT.

Materials And Methods: A total of 36 patients who had TAVR planning axial CT on a wide-detector scanner (protocol 1) were compared to 36 patients who had helical 4 cm detector CT (protocol 2).

Results: Vascular attenuation was greater for protocol 1, but image noise, contrast-to-noise ratio, and signal-to-noise ratio were the same.

Dual-energy CT Aortography with 50% Reduced Iodine Dose Versus Single-energy CT Aortography with Standard Iodine Dose.

Rationale And Objectives: Because many patients with aortic pathology also have compromised renal function, we wished to investigate dual-energy computed tomography (DECT) aortography with 50% reduced iodine dose compared to single-energy computed tomography (SECT) aortography with standard iodine dose.

Materials And Methods: Fifty patients had DECT aortography with 50% reduced iodine dose. Thirty-four of these patients had prior SECT aortography with standard iodine dose.

Standard and reduced radiation dose liver CT images: adaptive statistical iterative reconstruction versus model-based iterative reconstruction-comparison of findings and image quality.

Purpose: To investigate whether reduced radiation dose liver computed tomography (CT) images reconstructed with model-based iterative reconstruction ( MBIR model-based iterative reconstruction ) might compromise depiction of clinically relevant findings or might have decreased image quality when compared with clinical standard radiation dose CT images reconstructed with adaptive statistical iterative reconstruction ( ASIR adaptive statistical iterative reconstruction ).

Materials And Methods: With institutional review board approval, informed consent, and HIPAA compliance, 50 patients (39 men, 11 women) were prospectively included who underwent liver CT. After a portal venous pass with ASIR adaptive statistical iterative reconstruction images, a 60% reduced radiation dose pass was added with MBIR model-based iterative reconstruction images.

Dual-energy liver CT: effect of monochromatic imaging on lesion detection, conspicuity, and contrast-to-noise ratio of hypervascular lesions on late arterial phase.

Objective: The purpose of this study was to evaluate the effect of use of dual-energy CT monochromatic imaging in the late hepatic arterial phase on hyperenhancing focal lesion detection and lesion conspicuity.

Subjects And Methods: This prospective study included 72 patients imaged with a single-source dual-energy CT scanner. Late arterial phase imaging was performed with dual energies of 140 and 80 kVp, and the portal venous and delayed phases were performed with a single energy of 120 kVp.

Side effects from use of one or more psychiatric medications in a population-based sample of children and adolescents.

Objective: The purpose of this study was to investigate the side effect risks from using one or more psychiatric medications (including antipsychotics, antidepressants, α-2 agonists, benzodiazepines, mood stabilizers, and stimulants) among a national cohort of children and adolescents.

Methods: A questionnaire survey was administered to parents who filled a prescription for a psychiatric medication for their child at a large national retail pharmacy chain. Primary outcome variables were the total count of side effects from a list of 12 problem areas, as well as parent-reported side effect intensity (mild/moderate/severe).

Community child psychiatric medication experiences measured by an internet-based, prospective parent survey of retail pharmacy customers.

One thousand five hundred parents filling a psychiatric prescription for their 6-18 year old child with a multi-state retail pharmacy chain received a single mailed invitation to complete a detailed online survey. 276 parents responded (18.4%).

Model-based iterative reconstruction versus adaptive statistical iterative reconstruction and filtered back projection in liver 64-MDCT: focal lesion detection, lesion conspicuity, and image noise.

Objective: The purpose of this study is to compare three CT image reconstruction algorithms for liver lesion detection and appearance, subjective lesion conspicuity, and measured noise.

Materials And Methods: Thirty-six patients with known liver lesions were scanned with a routine clinical three-phase CT protocol using a weight-based noise index of 30 or 36. Image data from each phase were reconstructed with filtered back projection (FBP), adaptive statistical iterative reconstruction (ASIR), and model-based iterative reconstruction (MBIR).

Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy.

Background: In patients with established cardiovascular disease, residual cardiovascular risk persists despite the achievement of target low-density lipoprotein (LDL) cholesterol levels with statin therapy. It is unclear whether extended-release niacin added to simvastatin to raise low levels of high-density lipoprotein (HDL) cholesterol is superior to simvastatin alone in reducing such residual risk.

Methods: We randomly assigned eligible patients to receive extended-release niacin, 1500 to 2000 mg per day, or matching placebo.

Prospectively ECG gated CT pulmonary angiography versus helical ungated CT pulmonary angiography: impact on cardiac related motion artifacts and patient radiation dose.

Objective: To compare prospectively ECG gated CT pulmonary angiography (CTPA) with routine helical ungated CTPA for cardiac related motion artifacts and patient radiation dose.

Subjects And Methods: Twenty patients with signs and symptoms suspicious for pulmonary embolism and who had a heart rate below 85 were scanned with prospectively ECG gated CTPA. These gated exams were matched for several clinical parameters to exams from twenty similar clinical patients scanned with routine ungated helical CTPA.

Adaptive statistical iterative reconstruction versus filtered back projection in the same patient: 64 channel liver CT image quality and patient radiation dose.

Objectives: To compare routine dose liver CT reconstructed with filtered back projection (FBP) versus low dose images reconstructed with FBP and adaptive statistical iterative reconstruction (ASIR).

Methods: In this retrospective study, patients had a routine dose protocol reconstructed with FBP, and again within 17 months (median 6.1 months), had a low dose protocol reconstructed twice, with FBP and ASIR.

Cardiac arrest survival did not increase in the Resuscitation Outcomes Consortium after implementation of the 2005 AHA CPR and ECC guidelines.

Introduction: We examined the effect of the 2005 American Heart Association guidelines on survival in the Resuscitation Outcomes Consortium (ROC) Cardiac Arrest Epistry.

Methods: We surveyed 174 EMS agencies from 8 of 10 ROC sites to determine 2005 AHA guideline implementation, or crossover, date. Two sites with 2005 compatible treatment algorithms prior to guideline release, and agencies that did not adopt the new guidelines during the study period were excluded.

The relationship between out-of-hospital airway management and outcome among trauma patients with Glasgow Coma Scale Scores of 8 or less.

Background: Airway management remains a fundamental component of optimal care of the severely injured patient, with endotracheal intubation representing the definitive strategy for airway control. However, multiple studies document an association between out-of-hospital intubation and increased mortality for severe traumatic brain injury.

Objectives: To explore the relationship between out-of-hospital intubation attempts and outcome among trauma patients with Glasgow Coma Scale (GCS) scores ≤ 8 across sites participating in the Resuscitation Outcomes Consortium (ROC).

Variation in out-of-hospital cardiac arrest resuscitation and transport practices in the Resuscitation Outcomes Consortium: ROC Epistry-Cardiac Arrest.

Objectives: To identify variation in patient, event, and scene characteristics of out-of-hospital cardiac arrest (OOHCA) patients assessed by emergency medical services (EMS), and to investigate variation in transport practices in relation to documented prehospital return of spontaneous circulation (ROSC) within eight regional clinical centers participating in the Resuscitation Outcomes Consortium (ROC) Epistry-Cardiac Arrest.

Methods: OOHCA patient, event, and scene characteristics were compared to identify variation in treatment and transport practices across sites. Findings were adjusted for site and standard Utstein covariates.

Delayed prehospital implementation of the 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiac care.

Introduction: In 2005, the American Heart Association (AHA) released guidelines to improve survival rates from out-of-hospital cardiac arrest (OHCA).

Objective: To determine if, and when, emergency medical services (EMS) agencies participating in the Resuscitation Outcomes Consortium (ROC) implemented these guidelines.

Methods: We contacted 178 EMS agencies and completed structured telephone interviews with 176 agencies.

Variation in the type, rate, and selection of patients for out-of-hospital airway procedures among injured children and adults.

Objectives: The objective was to compare the type, rate, and selection of injured patients for out-of-hospital airway procedures among emergency medical services (EMS) agencies in 10 sites across North America.

Methods: The authors analyzed a consecutive patient, prospective cohort registry of injured adults and children with an out-of-hospital advanced airway attempt, collected from December 1, 2005, through February 28, 2007, by 181 EMS agencies in 10 sites across the United States and Canada. Advanced airway procedures were defined as orotracheal intubation, nasotracheal intubation, supraglottic airway, or cricothyrotomy.

Genome-wide scan for quantitative trait loci influencing LDL size and plasma triglyceride in familial hypertriglyceridemia.

Small, dense LDLs and hypertriglyceridemia, two highly correlated and genetically influenced risk factors, are known to predict for risk of coronary heart disease. The objective of this study was to perform a whole-genome scan for linkage to LDL size and triglyceride (TG) levels in 26 kindreds with familial hypertriglyceridemia (FHTG). LDL size was estimated using gradient gel electrophoresis, and genotyping was performed for 355 autosomal markers with an average heterozygosity of 76% and an average spacing of 10.

DNA fingerprinting abnormalities can distinguish ulcerative colitis patients with dysplasia and cancer from those who are dysplasia/cancer-free.

Patients with extensive ulcerative colitis (UC) of longer than 8 years duration are at high risk for the development of colorectal cancer. The cancers in these patients appear to develop in a stepwise manner with progressive histological changes from negative for dysplasia --> indefinite for dysplasia --> dysplasia --> cancer. The aim of this study was to determine the timing and extent of genomic instability in the progression of UC dysplasia and cancer.