The impact of dependence on advanced imaging techniques on the current radiology practice

DIVERT-Ca: unveiling the hidden link between acute diverticulitis and colorectal cancer risk-multicentre retrospective study

INTRODUCTION

Colorectal cancer (CRC) is the third most common cancer worldwide, accounting for approximately 10% of all malignancies. Emerging trends of association with risk factors such as diverticulitis highlight the need for updated screening and follow-up protocols. We aimed to examine risk factors associated with the development of CRC within 12 months following an episode of acute diverticulitis, and identify areas to streamline follow-up.

METHODS

We performed a retrospective multicentre study of adult patients admitted in 2022 with computed tomography (CT) confirmed acute diverticulitis across four large NHS Trusts in the UK. Patient demographics, comorbidities, clinical presentation, vital signs, laboratory results, details of in-patient stay, and follow-up investigations were collected and analysed. Our primary outcome was the incidence of CRC within 12 months of index presentation with acute diverticulitis. Analysed secondary outcomes were potential patient risk factors associated with a diagnosis of CRC and follow-up protocols. All statistical analysis was performed using R (version 4.4) and P-values of < 0.05 were considered statistically significant.

RESULTS

A total of 542 patients with acute diverticulitis over the study period were included. The median age of our cohort was 62 (51-73) years, and 204 (37.6%) were male. Ten (1.8%) patients were diagnosed with CRC within the 12-month period. Hinchey grade Ib was significantly associated with CRC (OR 4.51, P = 0.028). Colonoscopic follow-up requests were associated with age between 40 and 60 years, mild white cell count (WCC) elevation, and a hospital stay of 3-7 days. Male gender, age between 18 and 40 years, and elevated C-reactive protein (CRP) were all strongly associated with CRC but not statistically significant. Follow-up was inconsistent with 53.7% of the cohort having luminal investigations.

CONCLUSION

The incidence of CRC was in-keeping with published literature. Hinchey grade 1b was significantly associated with a subsequent CRC diagnosis. These findings emphasise the need for specialised radiological review of CT scans to detect underlying malignancy. Moreover, standardised follow-up protocols following an episode of acute diverticulitis are needed to avoid missing malignant lesions.

Theranostic Approaches for Gastric Cancer: An Overview of In Vitro and In Vivo Investigations

Gastric cancer (GC) is the second most common cause of cancer-related death worldwide and a serious public health concern. This high death rate is mostly caused by late-stage diagnoses, which lead to poor treatment outcomes. Radiation immunotherapy and targeted therapies are becoming increasingly popular in GC treatment, in addition to surgery and systemic chemotherapy. In this review, we have focused on both in vitro and in vivo research, which presents a summary of recent developments in targeted therapies for gastric cancer. We explore targeted therapy approaches, including integrin receptors, HER2, Claudin 18, and glutathione-responsive systems. For instance, therapies targeting the integrin receptors such as the αvβ3 and αvβ5 integrins have shown promise in enhancing diagnostic precision and treatment efficacy. Furthermore, nanotechnology provides novel approaches to targeted drug delivery and imaging. These include glutathione-responsive nanoplatforms and cyclic RGD peptide-conjugated nanoparticles. These novel strategies seek to reduce systemic toxicity while increasing specificity and efficacy. To sum up, the review addresses the significance of personalized medicine and advancements in gastric cancer-targeted therapies. It explores potential methods for enhancing gastric cancer prognosis and treatment in the future.

Ultrasound Imaging in Diagnosis and Management of Lower Limb Injuries: A Comprehensive Review

Medical imaging tests are widely used to diagnose a broad spectrum of lower-limb injuries. Among these modalities, ultrasound (US) imaging has gained significant traction as a valuable diagnostic instrument for assessing conditions primarily affecting muscles, tendons, ligaments, and other soft tissues. However, there are important dilemmas related to the indications and possibilities of US in lower-limb injuries. Conflicting findings and approaches raise questions regarding the validity, accuracy, and usefulness of the US in that area. This narrative review attempts to summarize the current state of knowledge regarding US imaging of lower-limb injuries. The study provides a detailed discussion of the existing literature and contemporary insights on the diagnosis of lower-limb injuries using US examination, and draws attention to the role of the US in interventional procedures and monitoring of the healing process. The characteristics of normal muscles, tendons, and ligaments in US imaging are presented, along with the most commonly documented conditions affecting these tissues. Furthermore, the benefits and justifications for employing US in interventional procedures are discussed, ranging from platelet-rich plasma injections to physiotherapeutic treatments like percutaneous electrolysis. The study was further augmented with US pictures depicting various lower-limb injuries, mainly affecting young athletes. This article aims to review the role of US imaging in the diagnosis and management of common lower-limb injuries.

Enhancing Imaging Anatomy Competency: Integrating Digital Imaging and Communications in Medicine (DICOM) Viewers Into the Anatomy Lab Experience

INTRODUCTION

Radiologic interpretation is a skill necessary for all physicians to provide quality care for their patients. However, some medical students are not exposed to Digital Imaging and Communications in Medicine (DICOM) imaging manipulation until their third year during clinical rotations. The objective of this study is to evaluate how medical students exposed to DICOM manipulation perform on identifying anatomical structures compared to students who were not exposed.

METHODS

This was a cross-sectional cohort study with 19 medical student participants organized into a test and control group. The test group consisted of first-year students who had been exposed to a new imaging anatomy curriculum (n = 9). The control group consisted of second-year students who had not had this experience (n = 10). The outcomes measured included quiz performance, self-reported confidence levels, and eye-tracking data.

RESULTS

Students in the test group performed better on the quiz compared to students in the control group (p = 0.03). Confidence between the test and control groups was not significantly different (p = 0.16), though a moderate to large effect size difference was noted (Hedges' g = 0.75). Saccade peak velocity and fixation duration between the groups were not significantly different (p = 0.29, p = 0.77), though a moderate effect size improvement was noted in saccade peak velocity for the test group (Hedges' g = 0.49).

CONCLUSION

The results from this study suggest that the early introduction of DICOM imaging into a medical school curriculum does impact students' performance when asked to identify anatomical structures on a standardized quiz.

The importance, benefits, and future of nanobiosensors for infectious diseases

Infectious diseases, caused by pathogenic microorganisms such as bacteria, viruses, parasites, or fungi, are crucial for efficient disease management, reducing morbidity and mortality rates and controlling disease spread. Traditional laboratory-based diagnostic methods face challenges such as high costs, time consumption, and a lack of trained personnel in resource-poor settings. Diagnostic biosensors have gained momentum as a potential solution, offering advantages such as low cost, high sensitivity, ease of use, and portability. Nanobiosensors are a promising tool for detecting and diagnosing infectious diseases such as coronavirus disease, human immunodeficiency virus, and hepatitis. These sensors use nanostructured carbon nanotubes, graphene, and nanoparticles to detect specific biomarkers or pathogens. They operate through mechanisms like the lateral flow test platform, where a sample containing the biomarker or pathogen is applied to a test strip. If present, the sample binds to specific recognition probes on the strip, indicating a positive result. This binding event is visualized through a colored line. This review discusses the importance, benefits, and potential of nanobiosensors in detecting infectious diseases.

Effects of a music-based intervention on psychophysiological outcomes of patients undergoing medical imaging procedures: A systematic review and meta-analysis

INTRODUCTION

Musical intervention (MI) is a valuable strategy for addressing the psychological and emotional challenges faced by patients undergoing imaging procedures. This study explores MI's impact on psychophysiological outcomes during imaging procedures, detailing the sound repertoire and technical characteristics employed in MI.

METHODS

A systematic review (SR) and meta-analysis (MA) were conducted. Electronic database searches of PubMed, Web-of-Science, and Scopus were performed encompassing original randomised research and quasi-experimental articles published until June 2023.

RESULTS

Thirteen articles were included in this SR, scoring between 23 and 68 on the Joanna Briggs Institute (JBI) Checklist. Four articles were included to perform a MA concerning anxiety and heart rate (HR) outcomes. Most studies utilised digital playlists as the medium for MI. Headphones were commonly used, with an average volume of 50-60 dB and a musical frequency of 60-80 beats/min. While authors generally preferred selecting musical genres for the repertoire, two articles specifically chose Johann Pachelbel's "Canon in D major" as their musical theme. In terms of psychological parameters, the experimental groups exhibited lower anxiety values than the control groups, with further reductions after MI. However, MA shows that this trend is only marginally significant. Patient comfort and overall examination experience showed improvement with MI. Regarding physiological parameters, HR, especially in the final phase of the examination, was significantly lower in the experimental group compared to the control group.

CONCLUSION

Across multiple studies, MI demonstrated the ability to reduce anxiety and HR. However, no specific music repertoire emerged as the most effective.

IMPLICATIONS FOR PRACTICE

MI arises as a painless, reliable, low-cost, and side-effect-free strategy, presenting imaging departments with a practical means to enhance patient comfort and mitigate anxiety and stress during medical procedures.

From Conservative Measures to Surgical Interventions, Treatment Approaches for Cubital Tunnel Syndrome: A Comprehensive Review

Cubital tunnel syndrome (CuTS) is a neuropathic condition characterized by the compression or irritation of the ulnar nerve at the elbow, resulting in a wide spectrum of symptoms ranging from pain and numbness to muscle weakness and impaired hand function. This comprehensive review delves into the diverse landscape of CuTS treatment approaches, emphasizing the importance of early intervention. The review explores how these strategies aim to alleviate symptoms and enhance patient well-being by beginning with conservative measures encompassing rest, splinting, medications, physical therapy, and lifestyle adjustments. Non-surgical medical interventions, including nerve gliding exercises, ultrasound-guided nerve injections, and orthotic devices, are considered alternative therapies for symptom relief. Surgical interventions, such as decompression procedures and emerging techniques, are discussed in detail, highlighting their indications and expected outcomes. Throughout this review, the critical role of patient-centered care is underscored, emphasizing the need for tailored treatment plans that respect individual preferences and goals. Recognizing the unique nature of each CuTS case, shared decision-making between patients and healthcare providers is advocated, ensuring that interventions align with specific patient needs. As research advances, promising developments in diagnosis, surgical techniques, and drug therapies offer hope for more effective management of CuTS, paving the way for improved symptom relief and enhanced nerve function.

Investigation of clinical findings and CT scan in children with minor head trauma

BACKGROUND

The most common cause of death or severe impairment in children older than one-year-old is traumatic brain injury (TBI). Assessing TBI in children with minor head trauma (MHT) using clinical findings from history-taking and a physical exam is crucial to minimizing unnecessary brain CTs and more accurately predicting TBI. We aimed to evaluate the findings of brain CT scans in children with mild head trauma and their relationship with clinical signs and symptoms to avoid unnecessary interventions in many children with MHT.

METHODS

This cross-sectional-analytical study was performed to evaluate the findings of brain CT scans in children with MHT and their relationship with clinical signs and symptoms that were referred to Poursina Hospital in Rasht in the first half of 2021. Children were divided into two age groups: under two years and 2-12 years, and analyzed separately. Initially, a list containing all demographic information, patients' clinical signs, and symptoms were prepared. The collected data were then analyzed using SPSS software version 26.

RESULTS

According to the results, the mean age of patients was 66.01 months and 88 were boys (56.4%). The most common mechanism of injury was falling from a height. Most patients had isolated head injuries. Among the accompanying injuries, facial injuries were the most common. Among the clinical factors studied, cranial fracture on CT scan and GCS less than 15 were significantly associated with the occurrence of traumatic brain injury on CT scan. In addition, cranial fracture on CT scan, injury severity, and history of vomiting had the highest positive predictive value, respectively.

CONCLUSION

Standard history and clinical examination are sufficient to identify high-risk cases of pediatric head injuries. GCS is the most important risk factor for pediatric MHT. Requesting a CT scan is not recommended without these risk factors.