The British journal of radiology
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Review Case Reports
Tracheal chondrosarcoma--a rare complication in Maffucci syndrome.
Maffucci syndrome is a rare congenital non-hereditary disease characterised by subcutaneous haemangiomata and multiple enchondromata. We present a case of an intermediate grade myxoid chondrosarcoma of the tracheal cartilage in a 34-year-old man with a history of Maffucci syndrome. ⋯ A review of the radiological literature reveals approximately 15 previously published cases. No case was found with a history of Maffucci syndrome.
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A wide spectrum of intracranial injuries has been described as complicating difficult birth, particularly following instrumental delivery. We describe five children in whom isolated cortical tears were observed on MRI. Four cases were characterised by a difficult instrumental delivery. ⋯ As far as we are aware, isolated cerebral cortical tears have not been reported previously although recognition of this injury pattern is important because of its possible misinterpretation as a marker of a non-accidental head injury. Other differential diagnoses that should be considered include cerebral infarcts, schizencephaly and accidental head injury. The importance of high-quality cross-sectional brain imaging in newborn infants with seizures is emphasised.
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Conversion factors for effective dose (CF(E) = effective dose/dose-area product (mSv (Gy cm2)(-1)) in paediatric interventional cardiology were estimated retrospectively for 249 patients using the dose-area product (DAP), irradiation geometry, exposure parameters and tissue-weighting factors (TWFs) from the International Commission on Radiological Protection (ICRP) 60. Two methods for estimating the conversion factors, which differed in the description of the irradiation geometry, were evaluated. The effective doses obtained with the two methods were almost identical. ⋯ With the new ICRP value for TWF(b), increases in the CFs in the order of 10-30%, and in the effective dose of 10-20%, were indicated. The results indicated that the effective dose in paediatric interventional cardiology is of much greater concern than the skin dose. Furthermore, age-dependent CF(E) values are required so as not to underestimate the doses to very young patients.
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This study was undertaken to determine the current level of resuscitation skills amongst staff in the Department of Clinical Radiology, University Hospital of Wales, and to identify ways of improving it. Questionnaires, which were modified according to expected level of expertise, were distributed to all staff members. 66% of the staff responded. 75% had formal resuscitation training, but the validation of this training had lapsed in 66%. 11% were aware of the location of all the resuscitation equipment in the department. Only 10% were aware of the new Resuscitation Council guidelines (changed in April 2006) regarding chest compression to ventilation ratio and hand position during chest compression. ⋯ Only 55% of medical staff could identify and manage a pneumothorax; and correctly measure and insert an oropharyngeal airway. 35% could use a defibrillator, but only 6% were aware of the changes to the guidelines for use of this equipment. Only one staff member was aware of the all the relevant changes in the guidelines. There is a shortfall of resuscitation skills in the radiology department and a responsibility on all radiology staff to update their resuscitation skills.
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Ureteric obstruction causing renal failure is a serious complication of advanced prostate cancer. Percutaneous nephrostomies (PCNs) are used to decompress the obstructed kidney(s). This study aims to identify whether bilateral PCN insertion confers any advantage over unilateral PCN insertion for patients with bilateral ureteric obstruction. ⋯ The mean survival time following PCN was 7.5 months for all patients. The data suggest that the nadir serum creatinine after PCN insertion was similar, independent of whether one or two nephrostomies were inserted. There was also little difference in the serum creatinine levels at the time of death, suggesting that survival after PCN insertion is based on the aggressiveness of the prostate cancer as opposed to the number of nephrostomies inserted.