Medicine
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The objective of this study was to assess the clinical role of apparent diffusion coefficient (ADC) analysis in noncystic focal liver lesion (FLL) classification/characterization. Six hundred liver magnetic resonances with multi-b (b = 50, 400, 800 s/mm) diffusion-weighted imaging (DwI) were retrospectively reviewed. Mean ADC was measured in 388 lesions (195 benign and 193 malignant) excluding internal necrotic areas. ⋯ Of all lesions, >1/3 (39.5%) presented values lower than 1 × 10 mm/s, with 90.0% chance of malignancy. Above 1.5 × 10 mm/s (about 20% of all lesions) chance of malignancy was 9.5%. DwI cannot assist in noncystic FLL characterization, but can help in FLL classification in about half the cases.
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Prominent T-wave inversions are well recognized electrocardiographic signs that can occur in acute myocardial infarction (AMI). However, the giant negative T waves may be associated with myocardial stunning without AMI. This case report describes 2 patients without AMI who developed rare giant T-wave inversions measuring up to 35 mm in depth and QT prolongation after admission to hospital. ⋯ The patients remained well. The electrophysiologic mechanism responsible for giant T-wave inversion with QT prolongation is presently unknown. The two cases demonstrate that the rare giant negative T waves may be associated with myocardial stunning without AMI.
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Ordinal-scale strength assessment methods currently used in Paralympic athletics classification prevent the development of evidence-based classification systems. This study evaluated a battery of 7, ratio-scale, isometric tests with the aim of facilitating the development of evidence-based methods of classification. This study aimed to report sex-specific normal performance ranges, evaluate test-retest reliability, and evaluate the relationship between the measures and body mass. ⋯ Allometric exponents were higher in males than in females (mean 0.99 vs 0.30). Results indicate that this comprehensive and parsimonious battery is an important methodological advance because it has psychometric properties critical for the development of evidence-based classification. Measures were interrelated with body size, indicating further research is required to determine whether raw measures require normalization in order to be validly applied in classification.
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To demonstrate the feasibility and clinical significance of cervical vestibular-evoked myogenic potential (cVEMP) test in pediatric patients. Retrospective review study was conducted in a pediatric tertiary care facility. A total of 278 patients were identified with adequate data, including medical notes, results of cVEMP, and imaging studies. ⋯ Obtained cVEMP results provided useful information in clinical diagnosis and management in all cases. It is feasible to conduct cVEMP testing in children, including infants, and cVEMP testing can provide valuable information in the diagnosis and management of hearing loss and vestibular impairment. This simple and noninvasive test should be embraced by pediatric professionals.
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Acute liver failure (ALF) is uncommon but fatal. Current management is based mostly on clinical experience. We aimed to investigate the incidence, etiology, outcomes, and prognostic factors of ALF in Taiwan. ⋯ Patients with malignancy and alcohol exposure have worst prognosis. The use of proton pump inhibitor is associated with improved survival. Half of the ALF survivors have liver cirrhosis.