Radiology
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The authors describe the computed tomographic (CT) appearances in three patients with pulmonary talcosis resulting from chronic intravenous drug abuse. There was widespread ground-glass attenuation in one case and an appearance similar to that of progressive massive fibrosis in two cases. In the latter cases, there were confluent perihilar masses with areas of high attenuation. While the CT appearances may be suggestive of pulmonary talcosis, tissue sampling is required for definitive diagnosis.
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Comparative Study
Pneumothorax: detection with upright versus decubitus radiography.
To evaluate the value of decubitus chest radiography in the clinical assessment of pneumothorax, the authors compared the detectability of pneumothorax on expiratory, upright chest radiographs with that on expiratory, lateral decubitus radiographs obtained with the suspected side up. Five radiologists reviewed 19 sets of radiographs with pneumothoraces and 20 sets of radiographs without pneumothoraces. ⋯ In three cases, however, decubitus positioning was more definitive. These results suggest that when clinically feasible, the expiratory, upright chest radiograph is the procedure of choice for the evaluation of small pneumothoraces.
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The authors present a prospective study of single-agent pediatric sedation regimens for patients older than 2 years of age undergoing magnetic resonance (MR) imaging of the brain and spine. Thirty patients underwent MR imaging after intravenous administration of pentobarbital in successive boluses of 2.5 mg/kg to a maximum of 7.5 mg/kg. Thirty-one patients received an intravenous bolus followed by continuous infusion of propofol. ⋯ Three patients receiving propofol experienced transient decreases in oxygen saturation, at variable times over the course of the procedure. However, patients recovered significantly faster from sedation with propofol. While propofol may represent a viable alternative to pentobarbital in selected patients, propofol requires constant physician supervision and meticulous technique.