PubMed Health⌕ Search

Biomedical subjects

C D Phillips

Publications and source records attributed to C D Phillips.

At least 73 records · Page 4Linked to original sources
PubMed1991

Dynamic CT of the neck.

The authors describe a technique for dynamic incremental computed tomography (CT) of the neck with use of slow-power intravenous injection of contrast material. CT scans of the necks of 55 subjects were evaluated with this technique and were found to exhibit adequate opacification of the neck vessels. This method of contrast enhancement enables vessels to be confidently distinguished from enlarged lymph nodes or masses. It also provides information about the boundaries of masses, their vascularity, and their relationship to surrounding structures. In addition, the authors have optimized this technique by reducing contrast material volume while maintaining diagnostic quality.

Humans↗
PubMed1990

Designing the national resident assessment instrument for nursing homes.

In response to the Omnibus Reconciliation Act of 1987 mandate for the development of a national resident assessment system for nursing facilities, a consortium of professionals developed the first major component of this system, the Minimum Data Set (MDS) for Resident Assessment and Care Screening. A two-state field trial tested the reliability of individual assessment items, the overall performance of the instrument, and the time involved in its application. The trial demonstrated reasonable reliability for 55% of the items and pinpointed redundancy of items and initial design of scales. On the basis of these analyses and clinical input, 40% of the original items were kept, 20% dropped, and 40% altered. The MDS provides a structure and language in which to understand long-term care, design care plans, evaluate quality, and describe the nursing facility population for planning and policy efforts.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1989

Computed tomography as a diagnostic aid in diabetic and other problem feet.

Determining whether osteomyelitis is present in patients with foot infections represents a significant diagnostic challenge. As bone uptake with nuclide scans can be affected by soft tissue infection, we performed computed tomography (CT) on seven patients to see if marrow or bone abnormalities could be seen and used to predict the presence or absence of osteomyelitis. The CT scans correctly predicted the presence or absence of osteomyelitis in all seven patients. Four patients had osteomyelitis and three patients did not. Nuclide bone scans had one false-positive and one false-negative result. In this small series, CT proved helpful in evaluating foot problems.

Adult↗
PubMed1988

Nontraumatic avulsion of the lesser trochanter: a pathognomonic sign of metastatic disease?

Isolated avulsion fractures of the lesser trochanter resulting from trauma are most commonly seen in adolescent athletes and are rare in adults. Standard therapy is nonsurgical with bedrest and immobilization of the leg. However, when this lesion is seen in the adult without significant trauma, it should be regarded as secondary to metastatic neoplasm until proven otherwise. Treatment should be surgical with prophylactic internal fixation of the hip to help prevent the commonly associated subtrochanteric pathologic fracture. In a patient without a known primary malignancy, biopsy should be carried out before therapy. We describe four patients with isolated avulsion fracture of the lesser trochanter due to metastatic carcinoma. Radiologists should be aware of this lesion because its presence has a decisive effect on therapy.

Adenocarcinoma↗
PubMed1987

Heterotopic chondro-ossification: a case report.

We report heterotopic chondro-ossification occurring in the hand of a young man in the absence of trauma. The differential diagnosis includes: bizarre periosteal osteochondromatous proliferations of the hands and feet, mature lesions of myositis ossificans, osteogenic sarcoma, confluent lesions of extra-articular synovial chondromatosis, and nodular forms of florid periostitis. True heterotopic bone formation is a benign condition, which of itself requires no specific treatment.

Adult↗
PubMed1986

The development of post-traumatic cyst-like lesions in bone.

Cyst-like lesions in the radius and tibia were observed in two children as a post-fracture event. The pathogenesis of these lesions is discussed. Cut sections from anatomic specimens display extensive hemorrhage in subperiosteal as well as endosteal and trabecular bone. Cysts arising from hemorrhagic resorption in various locales may explain the occasional atypical appearance of these lesions.

Bone Cysts↗
PubMedDate not supplied

Gadolinium-enhanced MRI of tumors of the head and neck.

High-resolution computed tomographic (CT) scanning and, more recently, magnetic resonance imaging (MRI) have provided more accurate evaluation of the extent of head and neck neoplasms. With increasing experience, better methodology is being developed to improve imaging accuracy. We present a series of patients with clinically proven neoplasms of the oropharynx and larynx, evaluated by MR using T1-weighted, T2-weighted, and post-gadolinium (Gd)-DTPA T1-weighted imaged. The concept behind the use of Gd-DTPA was that it might permit the use of only pre- and postcontrast T1-weighted sequences, reducing examination time and increasing the sensitivity of the examination. It was also anticipated that Gd-DTPA could increase tumor conspicuity and edge definition. Imaging planes were chosen to best define the tumor extent and axial images were performed to evaluate adenopathy. The imaging results were compared with the clinical evaluation and with non-Gd-enhanced MRI. We present examples of the significantly improved soft tissue contrast with Gd-DTPA T1-weighted images and discuss the improved tumor margin definition with Gd-DTPA. Those cases in which it does not provide improved information will also be presented.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Individual Assessment Profile (IAP). Standardizing the assessment of substance abusers.

The Individual Assessment Profile (IAP), a structured intake assessment interview instrument in the public domain, was designed for use with substance-abusing populations in several large-scale and community-based drug abuse treatment projects underway in the United States. Background information is presented, including the content-based item-selection process used during the pretests and pilot testing. Validity and test-retest reliability data are also presented, along with descriptions of studies using the IAP for clinical, research, and management information purposes. Concordance between biological measures and self-reports of recent drug use, measures of internal consistency, and test-retest reliability coefficients were generally good. A computer-assisted personal interview version of the IAP and an automated reporting system were subsequently developed for clinical and management reporting purposes and used in a large-scale research demonstration project. An intreatment version of the IAP has also been developed to collect information on treatment services provided and to assess changes in behaviors after 3, 6, and 12 months of treatment. These instruments (the IAP intake and intreatment interviews) provide a comprehensive system to assess substance-abusing populations.

Adolescent↗
PubMedDate not supplied

Current indications and techniques in evaluating inflammatory disease and neoplasia of the sinonasal cavities.

Imaging strategies of the sinonasal cavities have undergone extensive revision over the last 5-year period. The traditional imaging examination of the paranasal sinuses, plain film radiography, does reasonably well in diagnosing maxillary, frontal, and sphenoid sinusitis. However, it less reliable in depicting abnormalities in the ethmoid sinuses, the most common area first affected with inflammatory disease. Compared with sinus computed tomography (CT), plain films prove to be less specific and sensitive in depicting the extent of sinus abnormalities. One series plainly concluded that sinus radiographs were not reliable enough to be an integral part of the clinical decision process. The use of plain radiographs of the sinuses has clearly been reduced by medical cost-containment concerns, replacement by superior techniques, and by clear weaknesses of the modality. Although it is inexpensive and easily accessible, the low sensitivities and inaccuracies of plain film radiography have resulted in the current use of CT and high-field-strength (1.5 Tesla) magnetic resonance imaging (MRI). By using this cross-sectional imaging, we now visualize directly the pathologic conditions within the sinuses, as well as the normal anatomy. We discuss current use of diagnostic imaging in the evaluation of patients with nasosinusoidal complaints (most commonly resulting from acute and chronic inflammatory disease), with complications of sinonasal inflammatory disease, and with suspected/documented neoplasia. In addition to developing an imaging algorithm to provide the information affecting clinical decision making, we detail the specific imaging techniques necessary accurately to obtain that information. We also review the specific concerns about imaging patients in the intensive care unit and touch on several emerging imaging techniques. The imaging workup in pediatric patients and patients with congenital anomalies is beyond the scope of this review.

Algorithms↗
PubMedDate not supplied

Oral cavity and oropharynx.

Cross-sectional imaging has become an essential element in the evaluation of disease processes involving the oral cavity and oropharynx. This article is an overview of the anatomy and typical pathology of the these areas. The radiologist, working in conjunction with the physical examination and the clinical evaluation of a careful head and neck surgeon, can provide information that is critical to the treatment of patients with oral cavity and oropharyngeal disease.

Diagnostic Imaging↗
PubMedDate not supplied

Extradural failure in glioblastoma multiforme: MRI demonstration.

Glioblastoma multiforme is invariably associated with intracranial failure following conventional therapy. Extracranial as well as metastatic failure are rarely seen. Subtle extracranial abnormalities in most patients with glioblastoma multiforme are not indicative of convexity failure. However, in patients with high p53 and Ki67 immunoreactivity and in whom the dura was not closed at the time of craniotomy, the possibility of early extradural failure should be considered.

Adult↗
PubMedDate not supplied

CT-guided percutaneous drainage of syringomyelia.

PURPOSE: Our purpose is to describe CT-guided percutaneous drainage of syringomyelia as a possible contribution in patient management. METHOD: CT-guided percutaneous drainage was performed on three patients with symptomatic syringomyelia. We determined the success of percutaneous decompression by subsequent CT and MRI. The effect of syringomyelia decompression in relation to the patient's symptoms was determined. This information was then used to help guide clinical management. RESULTS: In Case 1, percutaneous drainage of a large syrinx in a C5 quadriplegic patient with increasing lower extremity spasticity demonstrated significant decompression by imaging but did not result in clinical improvement. A surgical procedure to decompress the syrinx was not performed on the basis of this information. In Case 2, percutaneous drainage of a large syrinx in a quadriplegic patient with increasing upper extremity numbness and weakness demonstrated significant decompression by imaging and resulted in sustained clinical improvement, temporarily obviating the need for surgery. In Case 3, percutaneous drainage of the rostral aspect of a septated syrinx cavity in a patient with a Chiari I malformation and a syringoperitoneal shunt in place resulted in decompression by imaging but failed to relieve the patient's newly developed symptoms. An additional shunt was therefore not placed. In no case did the patient experience periprocedural complications or worsening of symptoms. CONCLUSION: CT-guided percutaneous drainage of syringomyelia is a safe and successful technique. It can be used diagnostically to identify patients that may or may not benefit from surgical syrinx decompression and in some cases may provide a temporary therapeutic alternative to surgery.

Adolescent↗