Industry and occupation in California birth certificates (1998-2019): Reporting disparities and classification codability.

Background: Missing and noncodable parental industry and occupation (I/O) information on birth certificates (BCs) can bias analyses informing parental worksite exposures and family economic stability.

Methods: We used the National Institute for Occupational Safety and Health (NIOSH) software to code parental I/O in 1989-2019 California BC data (N = 21,739,406). We assessed I/O missingness and codability by reporting period, parental sex, race/ethnicity, age, and education.

Role of magnetic resonance imaging in the diagnosis of bilateral facial paralysis.

Bilateral facial paralysis (BFP) is a rare clinical finding that may be caused by Guillain-Barré syndrome, a medical emergency. The differential diagnosis of BFP is lengthy but can be narrowed to a limited group of disorders by the patient's history and physical examination. The most important diagnostic tests to obtain initially are the lumbar puncture and magnetic resonance imaging (MRI) scan with gadolinium contrast enhancement.

Magnetic resonance imaging of brain herniation into the middle ear.

Four patients with cholesteatoma were shown to have a large area of eroded tegmen tympani on computed tomography (CT). Magnetic resonance imaging (MRI) in the coronal and sagittal plane showed temporal lobe herniation in three cases and cholesteatoma with abscess elevating the dura in one case. In the patient with a cholesteatoma and an eroded tegmen tympani on CT, MRI is indicated to rule out brain herniation into the middle ear.

Computed tomography and differential diagnosis of the extruded lumbar disc.

Herniated lumbar discs may infrequently extrude through or around the posterior longitudinal ligament and migrate within the epidural space either as a contiguous mass with or as a free fragment of the parent nucleus pulposus. Recognition of this entity may obviate the use of chymopapain or may otherwise alter the surgeon's approach to the disc herniation. The CT scans of 40 surgically confirmed cases of lumbar disc extrusion were reviewed.

Positional variations of the common carotid artery bifurcation: implications for digital subtraction angiography.

A retrospective examination of the arteriograms of 200 common carotid artery bifurcations was undertaken to determine the number of instances in which, because of superimposition of the external carotid artery in relation to the internal carotid artery, a lateral view would be required to profile the bifurcation fully. Although oblique views did adequately demonstrate the bifurcation in the majority of instances (124/200, 62%), the lateral view was clearly required for a diagnostically adequate display of the bifurcation in 37% (74/200) of instances. Therefore, if digital radiographs do not profile the bifurcation, a lateral arteriogram should be included in the radiographic examination; some serious, treatable abnormalities will otherwise go undetected.