Stenberg v. Carhart: women retain their right to choose.
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Abortion, Induced↗
Biomedical subjects
J F Berkowitz
Publications and source records attributed to J F Berkowitz.
Diagnostic imaging: special needs of older patients.
A wide variety of imaging techniques is available to assess the presence or extent of disease in the geriatric patient. Modalities range from the simple radiograph to more invasive techniques that may be poorly tolerated. Radiologic exams are used to test a wide range of conditions in the elderly, including respiratory disease, breast cancer, gastrointestinal and genitourinary disorders, skeletal disease, vascular disease, and neurologic illnesses. Selection of the proper test begins by matching the suspected disorder with the least invasive examination. More invasive tests are ordered next, if necessary. Consultation with radiology staff can help to optimize test selection.
Diagnostic Imaging↗
Plantar fasciitis: MR imaging.
The clinical presentation of plantar fasciitis may be mimicked by a number of other painful heel conditions. Thus, magnetic resonance (MR) imaging was used to develop objective morphologic criteria to establish a diagnosis of plantar fasciitis in eight patients. Sagittal T1-weighted and coronal intermediate and T2-weighted images of symptomatic and asymptomatic feet were obtained; additional sequences were used for symptomatic feet. Maximum thickness of the plantar fascia was significantly increased (P less than .0001) in patients with plantar fasciitis (sagittal, 7.40 mm +/- 1.17, and coronal, 7.56 mm +/- 1.01) compared with age- and sex-matched volunteers (sagittal, 3.22 mm +/- 0.44, and coronal, 3.44 mm +/- 0.53) and young male controls (sagittal, 3.00 mm +/- 0.8, and coronal, 3.00 mm +/- 0.0). Furthermore, nine of 10 feet with plantar fasciitis had areas of moderately increased signal intensity in the substance of the fascia. MR imaging may provide an objective assessment of the morphologic changes associated with plantar fasciitis, as well as assist in excluding other causes of heel pain.
Adult↗
Counseling before laryngectomy.
Counseling of laryngectomy patients was studied by a questionnaire survey among 294 fellows of the American Society for Head and Neck Surgery and otolaryngology house officers (77% attendings and 23% residents). Seventy-nine percent of respondents spent less than one hour counseling patients. Subjects emphasized during preoperative counseling included: extent of surgery, loss of speech, alternatives to surgery, immediate postoperative disfigurement, possible effects of surgery on life expectancy, and possibility of recurrence. At least 24% of physicians were unwilling to discuss the psychosocial effects laryngectomy. Ninety-five percent of respondents often or always included family members in preoperative counseling sessions. The speech pathologist was utilized by at least 80% of the respondents to help with preoperative counseling. Differences in counseling practices between attendings and residents are discussed.
Adult↗
Assessment of the cortical rim sign in posttraumatic renal infarction.
PURPOSE: The cortical rim sign has frequently been described as a sign of renal infarction. It is reported to be present in approximately 50% of focal or global infarcts and is thought to be due to an intact renal collateral circulation. This study evaluates the incidence and temporal development of the cortical rim sign in posttraumatic renal vascular compromise. METHOD: This retrospective study included 20 patients who were diagnosed by contrast-enhanced CT to have posttraumatic focal or global infarcts. The CT scans were reviewed to evaluate the size of infarcts and the presence and appearance of the rim sign. Medical records were reviewed to identify the timing of trauma in relation to the CT examination. RESULTS: Eight patients had multiple CT examinations and 12 had a single CT study. For all cases that demonstrated a rim sign (n = 14, 8 of which had more than one CT), the earliest appearance of the rim sing was 8 h (median time to appearance was 7 days). All cases with no rim sign (n = 6) were evaluated within 10 h of trauma, with a median time of 4 h. CONCLUSION: This study suggests that in spite of the presence of renal collateral circulation, it takes a minimum period of 8 h after trauma for this circulation to expand and become apparent on CT. CT demonstrated a rim sign in all cases performed after 1 week.
Adolescent↗