Antituberculosis therapy combined with corticosteroids and control of intracranial pressure constitutes the mainstay of therapy for tuberculous meningitis. Despite these treatment measures, some patients develop blindness, mainly as a result of progressive optochiasmatic arachnoiditis. This led us to explore the role of adjuvant thalidomide therapy, and we describe the dramatic recovery of vision in 4 consecutive cases. Clinical recovery was accompanied by marked radiological improvement
on magnetic resonance imaging (MRI) of the brain.”
“Purpose: To assess compliance and resultant radiation dose reduction with new pediatric chest and abdominal computed tomographic (CT) protocols based on patient weight, clinical indication, number of prior CT studies, and automatic exposure control.
Materials and Methods: The study was institutional Neuronal Signaling inhibitor review board approved and HIPAA compliant. Informed consent was waived. The new pediatric CT protocols, which were organized HIF inhibitor into six color zones based on clinical indications and number of prior CT examinations in a given patient, were retrospectively assessed. Scanning parameters were adjusted on
the basis of patient weight. For gradual dose reduction, pediatric CT (n = 692) examinations were performed in three phases of incremental stepwise dose reduction during a 17-month period. There were 245 male patients and 193 female patients (mean age, 12.6 years). Two radiologists independently reviewed CT images for image quality. Data were analyzed by using multivariate analysis of variance.
Results: Compliance MLN8237 with the new protocols in the early stage of implementation ( chest CT, 58.9%;
abdominal CT, 65.2%) was lower than in the later stage ( chest CT, 88%; abdominal CT, 82%) ( P < .001). For chest CT, there was 52.6% (9.1 vs 19.2 mGy) to 85.4% (2.8 vs 19.2 mGy) dose reduction in the early stage of implementation and 73.5% (4.9 vs 18.5 mGy) to 83.2% (3.1 vs 18.5 mGy) dose reduction in the later stages compared with dose at noncompliant examinations (P < .001); there was no loss of clinically relevant image quality. For abdominal CT, there was 34.3% (9.0 vs 13.7 mGy) to 80.2% (2.7 vs 13.7 mGy) dose reduction in the early stage of implementation and 62.4% (6.5 vs 17.3) to 83.8% ( 2.8 vs 17.3 mGy) dose reduction in the later stage ( P < .001).
Conclusion: Substantial dose reduction and high compliance can be obtained with pediatric CT protocols tailored to clinical indications, patient weight, and number of prior studies.”
“Introduction and objectives. The Global Registry of Acute Coronary Events (GRACE) risk score provides an estimate of the probability of death within 6 months of hospital discharge in patients with acute coronary syndrome (ACS). Our aim was to assess the validity of this risk score in a contemporary cohort of patients admitted to a Spanish hospital.
Methods.