Abdominal Radiology Group Australia & New Zealand (ARGANZ) 2015 in Melbourne, Australia
16 Tuesday Dec 2014
Posted Conferences
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The objective of our study was to evaluate the frequency, outcome, and appropriateness of treatment of adults with acute allergiclike reactions related to IV-administered nonionic iodinated contrast media.
For IV injections of nonionic iodinated contrast media between January 1, 1999, and December 31, 2005, contrast reaction reports and medical records of patients in whom contrast reactions occurred were reviewed. Data collected included patient sex and age, symptoms, reaction manifestations, treatment, and long-term sequelae. The appropriateness and efficacy of patient management were assessed.
Allergic-type reactions occurred in 545 (0.6%) of patients injected with nonionic iodinated contrast media: 418 (77%) reactions were mild, 116 (21%) were moderate, and 11 (2%) were severe. Two hundred twenty-one patients (41%) received treatment. The most commonly administered medication was diphenhydramine (145 patients or 27%). Corticosteroids were administered to 17 patients, nebulized albuterol to 16, and epinephrine to 15. Although 99% of the treatments did not result in any complication, three patients may have had short-term sequelae as a result of receiving a nonrecommended treatment.
Patients usually do well after developing acute allergiclike reactions to nonionic iodinated contrast media. Fortunately, in our series, this was true even in the rare cases in which the instituted treatment was considered to be inappropriate. Reacting patients rarely develop serious long-term sequelae.
06 Saturday Dec 2014
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Gaca AM1, Frush DP, Hohenhaus SM, Luo X, Ancarana A, Pickles A, Frush KS.
To prospectively develop and test a simulation model for assessing radiology resident preparedness for pediatric life-threatening events in the radiology environment.
This study was institutional review board approved. Nineteen radiology residents (10 men, nine women; mean age, 28.5 years) participated in two simulated contrast material reaction scenarios: one with and one without resuscitation aids available. Each resident examined and managed two mannequins-simulating a 1-2-year-old patient and an 8-9-year-old patient-for type, sequence, dose, and administration route for any intervention, including administering medication, calling a code team, and providing oxygen. The time to order each intervention was documented. Resident responses (time to order intervention, appropriateness of intervention, and intervention route) were evaluated. The paired t test was used to compare the time to intervention between the resuscitation-aid-available and resuscitation-aid-not-available scenarios and between the scenario performed first and the scenario performed second. The McNemar test was performed to compare the percentage of appropriate interventions between the two resuscitation aid scenarios.
The average time to call the code team was shorter when no resuscitation aids were available than when resuscitation aids were available (98 vs 149 seconds, P=.08). The average times to request oxygen and epinephrine were shorter when resuscitation aids were available (40 vs 89 seconds to request oxygen, P=.016; 121 vs 163 seconds to request epinephrine, P=.21). Appropriate medication dosing was not significantly different between the two scenarios. In only five of the 38 simulated scenarios was calling the code team the first intervention. The correct sequence of interventions (calling code team, providing oxygen, and then providing epinephrine) was performed by only one resident in one scenario. Only five residents recognized that they were encountering a contrast material reaction.
Simulation training for radiology residents is valuable and suggests that resident preparedness for pediatric anaphylaxis from intravenous contrast media is insufficient. Clear step-by-step resuscitation aids are needed in the radiology environment.
06 Saturday Dec 2014
Posted Past Interview Questions
inWe sought to identify the criteria that academic radiology departments in the United States consider for selecting their residents.
In a cross-sectional study, a validated survey was sent to all the program directors of radiology residency programs. A total of 25 variables were studied. Descriptive statistics and correlations were calculated by the chi2 test. Nonparametric correlations were calculated with the Kruskal-Wallis rank test. Statistical significance was set at 5% alpha-error level (P<.05).
We had a response rate of 53.1% (77 of 145). All responders participate in the National Resident Matching Program (NRMP), and 93.5% fill all their positions through NRMP. The preinterview selection criteria showed no significant difference by size, region, or affiliation with a medical school. An “interviewing body” carries out the interview process in 87.3% of the cases. Residents and fellows are part of the interviewing body in 76.5% of the programs, the body has the final word in accepting candidates in 62.9% of the programs, 55.4% of the programs use score sheets during interviews with candidates, and only 6.5% of the programs perform panel interviews. Programs associated with a medical school are significantly more likely to have more members in their interviewing body and to use score sheets when evaluating candidates, and panel interviews (more than one candidate or interviewer) are significantly more common among programs in the northeast region.
All preinterview selection criteria and some interview structural characteristics are independent of the program’s size, region, or affiliation with a medical school. More research regarding optimal preselection and interview processes is needed, and closer attention should be paid to the NRMP process if current practices are to be maintained
05 Friday Dec 2014
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Bartlett MJ, Bynevelt M. Acute contrast reaction management by radiologists: a local audit study. Australasian Radiology 2003;47:363– 367.
(Department of Diagnostic Imaging and Interventional Radiology, Royal Perth Hospital, Perth, Western Australia, Australia)
Consultant radiologists & trainees must possess knowledge of optimal acute management of contrast reactions because patient survival depends upon prompt initial management
02 Tuesday Dec 2014
Posted Uncategorized
inImage guided percutaneous renal biopsy, utilising either ultrasound or CT allows for an accurate, reliable method of acquiring renal tissue for histopathological assessment.
Biopsy make be of a native or transplant kidney. It is divided into two types:
Either type may be performed as a CT guided biopsy or as an ultrasound guided biopsy 1. Recent description has been given of the use of 3D cone beam CT in assisting the biopsy of particularly challenging focal lesions 2.
This depends on both patient and operator factors, such as patient body habitus, ability to cooperate and operator experience. Transplant renal biopsy is usually undertaken with ultrasound guidance given its more superficial location in the pelvis.
An alternative option for percutaneous CT/US guidance is the transjugular renal biopsy.
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02 Tuesday Dec 2014
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02 Tuesday Dec 2014
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Radiology & adrenal gland
Nuclear medicine
The adrenal gland
Neurovascular & lymphatic anatomy
Normal variants of the adrenal glands
01 Monday Dec 2014
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Definition:
Terminology:
How it works:
Risks:
NB:
CVC can be divided into