Ordering of computed tomography scans for head and cervical spine: a qualitative study exploring influences on doctors' decision-making.

Background: Ordering of computed tomography (CT) scans needs to consideration of diagnostic utility as well as resource utilisation and radiation exposure. Several factors influence ordering decisions, including evidence-based clinical decision support tools to rule out serious disease. The aim of this qualitative study was to explore factors influencing Emergency Department (ED) doctors' decisions to order CT of the head or cervical spine.

18F-FDG PET/CT in Osteoradionecrosis of the Hyoid.

Osteoradionecrosis (ORN) is a well-documented complication following radiation treatment for head and neck malignancy. Facial bones, mainly the mandible, laryngeal cartilage, and skull, are frequently involved sites for ORN. A rare site for ORN is the hyoid, with very limited cases described in the literature.

A rare case of adult type ALCAPA syndrome: presentation, diagnosis and management.

We report a case of a 43 year-old previously fit and healthy woman presenting with cardiac arrest secondary to an anomalous origin of the Left Coronary Artery from the Pulmonary Artery (ALCAPA) Syndrome, a very rare congenital anomaly that it is extremely unusual to survive to adulthood if left uncorrected. To our knowledge, this is the first case of its type to be diagnosed and reported in an Australian hospital. Suspicion of this anomaly on conventional coronary angiography is essential given the life threatening nature of this condition.

What is the optimal clinical technique for measurement of left ventricular volume after myocardial infarction? A comparative study of 3-dimensional echocardiography, single photon emission computed tomography, and cardiac magnetic resonance imaging.

Background: Left ventricular (LV) volumes have important prognostic implications, but are commonly underestimated. We sought accuracy and reproducibility of LV volume measurement by live 3-dimensional (3D) echocardiography (3DE) and TI-201 single photon emission computed tomography (SPECT), compared with cardiac magnetic resonance imaging (MRI).

Methods: In all, 30 patients (age 62 +/- 9 years, 23 men) underwent LV volume assessment with 3DE, SPECT, and cardiac MRI after myocardial infarction.

Leflunomide-associated pancytopenia with or without methotrexate.

Objective: To report 18 cases of pancytopenia associated with leflunomide use in Australia, 5 of which were treated at Princess Alexandra Hospital, Brisbane. case summaries: Leflunomide was used in the treatment of rheumatoid arthritis in 17 of 18 patients; the other patient was diagnosed with systemic lupus erythematosus. Median age was 65.