Biomedical subjects

Friedrich M Lomoschitz

Publications and source records attributed to Friedrich M Lomoschitz.

4 recordsLinked to original sources

PubMed2004

Cervical spine fractures in patients 65 years and older: a clinical prediction rule for blunt trauma.

PURPOSE: To determine clinical predictors of cervical spine fracture in the elderly and to develop a clinical prediction rule to guide appropriate imaging in high-risk patients. MATERIALS AND METHODS: Institutional review board approval was received with waiver of informed consent. A retrospective case-control study was performed on blunt trauma patients 65 years and older with cervical spine fractures and on randomly selected control subjects without fracture. Potential predictors of fracture were evaluated through simple and multivariate logistic regression. Simple predictors were grouped into clinically similar composite variables and were analyzed with multivariate logistic regression and recursive partitioning. A clinical prediction rule was generated. The receiver operating characteristic curve was calculated and adjusted through bootstrap validation. Absolute cervical spine fracture probabilities were calculated by using Bayes theorem for all elderly patients and for patients who underwent computed tomography. Results were compared with a previous prediction rule for all adults. RESULTS: Composite predictors of fracture in the elderly included focal neurologic deficit (adjusted odds ratio, 17.7; 95% confidence interval [CI]: 3.8, 83.4), severe head injury (odds ratio, 3.2; 95% CI: 1.5, 7.1), high-energy mechanism (odds ratio 6.7; 95% CI: 3.1, 14.8), and moderate-energy mechanism (odds ratio 3.3; 95% CI: 1.3, 8.3). The prediction rule stratified patients into risk groups with fracture probabilities ranging from 0.4% (95% CI: 0.1%, 1.3%) to 24.2% (95% CI: 5.7%, 100%). CONCLUSION: Clinical factors can be used to stratify patients 65 years and older into risk groups with a wide range of probabilities of cervical spine fracture. Knowledge of cervical fracture risk can help guide appropriate imaging in high-risk patients.

Aged↗

PubMed2004

Stereotactic 11-gauge vacuum-assisted breast biopsy: influence of number of specimens on diagnostic accuracy.

PURPOSE: To determine whether number of specimens obtained at stereotactic 11-gauge vacuum-assisted breast biopsy with the patient prone influences diagnostic accuracy and to determine whether this number varies depending on mammographic appearance of lesions as masses or microcalcifications. MATERIALS AND METHODS: Biopsy was prospectively performed in 100 patients (median age, 55 years; range, 31-81 years) with 100 lesions that were mammographically evident as masses (n = 50) and microcalcifications (n = 50) with standardized protocol to acquire 20 specimens per lesion in three 360 degrees probe rotations at one skin entry site. Specimens were histologically evaluated sequentially, and findings were compared with results of surgical excision or of mammographic follow-up for at least 24 months. Differences in diagnostic yield after each probe rotation and differences in diagnostic yield between masses and microcalcifications were determined with chi(2) test. RESULTS: Up to 12 specimens harvested within two 360 degrees probe rotations were necessary to yield correct diagnosis in 96% of patients with masses and 92% of patients with microcalcifications. Diagnostic yield was not improved with more than 12 specimens for masses or microcalcifications. In two (4%) of 47 patients with lesions that were eventually diagnosed as cancer, results at stereotactic biopsy indicated they were benign. Underestimation of diagnosis of lesions as atypical ductal hyperplasia and ductal carcinoma in situ occurred in two (50%) of four and two (17%) of 12 lesions, respectively. With 20 specimens harvested during three probe rotations, there was no statistically significant difference in diagnostic yield between patients with masses and those with microcalcifications (P =.68). CONCLUSION: At 11-gauge vacuum-assisted biopsy, highest diagnostic yield was achieved with 12 specimens per lesion, independent of mammographic appearance of the lesion. Even with standardized retrieval of 20 specimens per lesion, underestimation of disease still occurs.

Adult↗

PubMed2003

Orbital apex injury: trauma at the junction between the face and the cranium.

Orbital apex injury is usually seen in multiply and severely injured patients who are subject to high-energy trauma. Orbital apex injury rarely occurs in isolation. By proximity, the face, the skull base, or their combination are the most likely regions to be injured in association with orbital apex trauma. The vast majority of these injuries occur as an extension of orbital, LeFort, naso-orbito-ethmoid, panfacial, sphenoid, or temporal bone fractures of the skull. Complex osseous anatomic structures with intimately related multiple neurovascular organs make injuries to the orbital apex diagnostically and therapeutically challenging. Often other facial fractures extend into the orbital apex, or the orbital apex is damaged in conjunction with fractures of the skull base. Therefore abnormal imaging findings within the orbital apex may be indicators of traumatic injury to the entire junctional zone of face and cranium. In this article, we will give an overview of normal CT anatomy, review clinical syndromes, which may indicate traumatic injury of the orbital apex and present an imaging strategy for evaluation of the orbital apex.

Humans↗

PubMed2003

Web-based image review and data acquisition for multiinstitutional research.

OBJECTIVE: In this article, we describe a user-friendly Web-based interface that allows review of images combined with integrated data collection and entry for use at multiple sites involved in a large multicenter research project. CONCLUSION: The Web-based system that we present uses a commercially available Internet browser and Web platform and allows automated data entry that can be easily uploaded into standard data analysis programs. The system simplifies the complex logistics of using multiple sites and reviewers for radiology research and can preserve human subject confidentiality. We tested the system using a large-scale multicenter cohort study of pelvic fracture-related hemorrhage (the "Evaluating Pelvic Hemorrhage" study). Program testing revealed seamless remote image interpretation and data acquisition.

Biomedical Research↗