The Experts below are selected from a list of 156 Experts worldwide ranked by ideXlab platform
Michael L Nance - One of the best experts on this subject based on the ideXlab platform.
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effective radiation dose from Radiologic Studies in pediatric trauma patients
World Journal of Surgery, 2005Co-Authors: Eileen Houseknecht, Delia Nickolaus, Soroosh Mahboubi, Michael L NanceAbstract:Evaluation of the pediatric trauma patient frequently requires Radiologic Studies. Although low-dose radiation from diagnostic radiology is considered safe, lifetime risks per unit dose of radiation are increased in children compared to adults. The total effective dose of radiation to a typical pediatric trauma patient is unknown. We sought to estimate the total effective dose of radiation related to the Radiologic assessment of injured children admitted to a pediatric Level I trauma center. We reviewed the radiology records of all children admitted directly to a trauma center in 2002 and tabulated all plain films, computed tomograms, angiographic/fluoroscopic Studies, and nuclear medicine Studies. Using age-adjusted effective doses (which incorporate biologic effects of radiation), we computed each patient’s total effective dose of radiation. Of 506 admitted patients, 394 (78%) underwent at least one Radiologic study. The mean total effective dose per patient was 14.9 mSv (median: 7.2 mSv; interquartile range: 2.2–27.4 mSv). On average, computed tomography accounted for 97.5% of total effective dose. Age and injury severity score did not predict total effective dose. We conclude that in pediatric trauma patients, the estimated total effective dose of radiation varied widely. Computed tomography contributed virtually the entire total effective dose. Regarding radiographic evaluation of pediatric trauma patients, the risks and benefits of current practices should continue to be evaluated critically, because lifetime risks associated with radiation exposure are inversely proportional to age at exposure.
Hyun Kwon Ha - One of the best experts on this subject based on the ideXlab platform.
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evaluation of suspected mesenteric ischemia efficacy of Radiologic Studies
Radiologic Clinics of North America, 2003Co-Authors: Hyun Kwon HaAbstract:Mesenteric ischemia is a common problem with protean causes. In patients with suspected mesenteric ischemia, early recognition of ischemic bowel and prompt management are crucial and directly connected to patients' prognosis. Because of its cross-sectional capability offering direct visualization of both enteric and perienteric changes, CT has become an essential diagnostic tool in these clinical settings. Although imaging features in mesenteric ischemia often are relatively nonspecific, understanding of the pathophysiology and clinical features of this disorder in various conditions, and Radiologic findings, helps the radiologist recognize the ischemic bowel and arrive at a correct diagnosis.
Barbra S Miller - One of the best experts on this subject based on the ideXlab platform.
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the role of Radiologic Studies in the evaluation and management of primary hyperaldosteronism
Surgery, 2008Co-Authors: Barbra S MillerAbstract:Background Surgical treatment of primary hyperaldosteronism (PHA) requires demonstration of unilateral adrenal hypersecretion. Optimal methods for interpretation of imaging and invasive testing are still in development. Methods A retrospective review from 1996–2007 of 106 patients with PHA was undertaken. Patient demographics, biochemical Studies, Radiologic imaging, operative reports, and pathology were reviewed and comparisons made. Optimal ratios for adrenal vein sampling were tested with regard to sensitivity and specificity. Preoperative and postoperative medication requirements and blood pressures were compared among different treatment groups. Results Seventy-eight patients (62 surgically treated) met criteria for inclusion. Median arterial blood pressure at diagnosis was 150/86 mm Hg while taking 3 antihypertensive medications. 69.2% required potassium supplementation. Median aldosterone:renin ratio was 107.0. Forty-two AVS procedures changed the management of 15 patients (35.7%) when compared to CT results. AVS accuracy was 96.6 vs 88.9% for NP-59 scintigraphy. Operative patients remained on fewer antihypertensive medications (1 vs 3), and mean systolic pressure was lower (130 vs 146 mm Hg) compared with medically managed patients. Conclusion When used together, pre-ACTH aldosterone ratios, normalized A/C:A/C ratios, ratios to define contralateral suppression, and post-ACTH stimulated values allowed for capture of episodically secreting tumors and subtle unilateral or bilateral hyperaldosteronism.
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the role of Radiologic Studies in the evaluation and management of primary hyperaldosteronism discussion
Surgery, 2008Co-Authors: Matthew L White, Barbra S Miller, Paul G Gauger, Gerard M Doherty, Norman W Thompson, Gary D Hammer, Anders BergenfelzAbstract:Background. Surgical treatment of primary hyperaldosteronism (PHA) requires demonstration of unilateral adrenal hypersecretion. Optimal methods for interpretation of imaging and invasive testing are still in development. Methods. A retrospective review from 1996-2007 of 106 patients with PHA was undertaken. Patient demographics, biochemical Studies, Radiologic imaging, operative reports, and pathology were reviewed and comparisons made. Optimal ratios for adrenal vein sampling were tested with regard to sensitivity and specificity. Preoperative and postoperative medication requirements and blood pressures were compared among different treatment groups. Results. Seventy-eight patients (62 surgically treated) met criteria for inclusion. Median arterial blood pressure at diagnosis was 150/86 mm Hg while taking 3 antihypertensive medications. 69.2% required potassium supplementation. Median aldosterone:renin ratio was 107.0. Forty-two AVS procedures changed the management of 15 patients (35.7%) when compared to CT results. AVS accuracy was 96.6 vs 88.9% for NP-59 scintigraphy. Operative patients remained on fewer antihypertensive medications (1 vs 3), and mean systolic pressure was lower (130 vs 146 mm Hg) compared with medically managed patients. Conclusion. When used together, pre-ACTH aldosterone ratios, normalized A/C:A/C ratios, ratios to define contralateral suppression, and post-ACTH stimulated values allowed for capture of episodically secreting tumors and subtle unilateral or bilateral hyperaldosteronism.
Eileen Houseknecht - One of the best experts on this subject based on the ideXlab platform.
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effective radiation dose from Radiologic Studies in pediatric trauma patients
World Journal of Surgery, 2005Co-Authors: Eileen Houseknecht, Delia Nickolaus, Soroosh Mahboubi, Michael L NanceAbstract:Evaluation of the pediatric trauma patient frequently requires Radiologic Studies. Although low-dose radiation from diagnostic radiology is considered safe, lifetime risks per unit dose of radiation are increased in children compared to adults. The total effective dose of radiation to a typical pediatric trauma patient is unknown. We sought to estimate the total effective dose of radiation related to the Radiologic assessment of injured children admitted to a pediatric Level I trauma center. We reviewed the radiology records of all children admitted directly to a trauma center in 2002 and tabulated all plain films, computed tomograms, angiographic/fluoroscopic Studies, and nuclear medicine Studies. Using age-adjusted effective doses (which incorporate biologic effects of radiation), we computed each patient’s total effective dose of radiation. Of 506 admitted patients, 394 (78%) underwent at least one Radiologic study. The mean total effective dose per patient was 14.9 mSv (median: 7.2 mSv; interquartile range: 2.2–27.4 mSv). On average, computed tomography accounted for 97.5% of total effective dose. Age and injury severity score did not predict total effective dose. We conclude that in pediatric trauma patients, the estimated total effective dose of radiation varied widely. Computed tomography contributed virtually the entire total effective dose. Regarding radiographic evaluation of pediatric trauma patients, the risks and benefits of current practices should continue to be evaluated critically, because lifetime risks associated with radiation exposure are inversely proportional to age at exposure.
Soroosh Mahboubi - One of the best experts on this subject based on the ideXlab platform.
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effective radiation dose from Radiologic Studies in pediatric trauma patients
World Journal of Surgery, 2005Co-Authors: Eileen Houseknecht, Delia Nickolaus, Soroosh Mahboubi, Michael L NanceAbstract:Evaluation of the pediatric trauma patient frequently requires Radiologic Studies. Although low-dose radiation from diagnostic radiology is considered safe, lifetime risks per unit dose of radiation are increased in children compared to adults. The total effective dose of radiation to a typical pediatric trauma patient is unknown. We sought to estimate the total effective dose of radiation related to the Radiologic assessment of injured children admitted to a pediatric Level I trauma center. We reviewed the radiology records of all children admitted directly to a trauma center in 2002 and tabulated all plain films, computed tomograms, angiographic/fluoroscopic Studies, and nuclear medicine Studies. Using age-adjusted effective doses (which incorporate biologic effects of radiation), we computed each patient’s total effective dose of radiation. Of 506 admitted patients, 394 (78%) underwent at least one Radiologic study. The mean total effective dose per patient was 14.9 mSv (median: 7.2 mSv; interquartile range: 2.2–27.4 mSv). On average, computed tomography accounted for 97.5% of total effective dose. Age and injury severity score did not predict total effective dose. We conclude that in pediatric trauma patients, the estimated total effective dose of radiation varied widely. Computed tomography contributed virtually the entire total effective dose. Regarding radiographic evaluation of pediatric trauma patients, the risks and benefits of current practices should continue to be evaluated critically, because lifetime risks associated with radiation exposure are inversely proportional to age at exposure.