AJR. American journal of roentgenology
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The aim of this article is to review the available evidence regarding image-guided percutaneous cryoneurolysis, with a focus on indications, technique, efficacy, and potential complications. ⋯ Percutaneous image-guided cryoneurolysis is safe and effective for the management of several well-described syndromes involving neuropathic pain. Additional rigorous prospective study is warranted to further define the efficacy and specific role of these interventions.
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Older women undergoing regular mammography experience significant reductions in breast cancer mortality, except in women with severe comorbidities or limited life expectancy. Optimizing screening strategies requires informed discussions of benefits and risks given each woman's health status. ⋯ This article will review the benefits and risks of screening mammography in women older than 75 years within the context of life expectancy and comorbidities and summarize the current recommendations from professional organizations for screening mammography in older women.
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AJR Am J Roentgenol · Feb 2018
ReviewScreening Mammography in Women 40-49 Years Old: Current Evidence.
Breast cancer is an important health problem for women 40-49 years old, yet screening mammography for this age group remains controversial. This article reviews recent guidelines and supporting evidence on screening mammography in women of this age group. ⋯ Evidence supports the benefit of annual screening mammography in women 40-49 years old. Models of different breast cancer screening strategies consistently show the greatest breast cancer mortality reduction and life-years gained with annual screening starting when women reach 40 years old.
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AJR Am J Roentgenol · Feb 2018
ReviewAge to Begin and Intervals for Breast Cancer Screening: Balancing Benefits and Harms.
Screening mammography has been widely used for breast cancer detection and has been found to decrease mortality, but debate continues. The purpose of this article is to review screening recommendations and the benefits and perceived harms of earlier and more frequent screening. ⋯ Annual mammography beginning at age 40 decreases mortality. Clinicians should educate women and preserve recommendations for early and annual screening.
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Headache in children is a common symptom and often is worrisome for clinicians and parents because of the breadth of possible underlying significant abnormalities, including meningitis, brain neoplasms, and intracranial hemorrhage. For this reason, many children with headaches undergo neuroimaging. Most neuroimaging studies performed of children with headaches have normal findings but may lead to significant downstream effects, including unnecessary exposure to ionizing radiation or sedation, as well as unnecessary cost to the health care system. In this article, we review the current evidence and discuss the role of neuroimaging in the diagnosis and management of pediatric headaches, with a special focus on tools that may aid in increasing the rate of positive findings, such as classification systems, algorithms, and red flag criteria. ⋯ Many tools exist that can help in improving the appropriateness of neuroimaging in pediatric headache. The main issues that remain to be addressed include scientific proof of safety and validity of these tools and clarity regarding the risks, benefits, and cost-effectiveness of CT versus MRI in various clinical settings and scenarios.