Australasian radiology
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Australasian radiology · Feb 2007
Central venous catheter placement by an interventional radiology unit: an Australian experience.
The aim of this retrospective study was to analyse the outcomes of central venous catheter (CVC) placement carried out by an interventional radiology unit. A review of our hospital records identified 331 consecutive patients who underwent insertion of a tunnelled or non-tunnelled CVC between January 2000 and December 2004. Key outcome measures included the technical success rate of CVC insertion and the percentage of immediate (<24 h), early (24 h-30 days) and late (>30 days) complications. ⋯ Catheter-related sepsis occurred in 2% of non-tunnelled CVC and 8.9% of tunnelled CVC. The overall incidence of catheter-related sepsis was 0.17 per 100 catheter days. As the demand for chemotherapy and haemodialysis grows with our ageing population, interventional radiology suites are well placed to provide a safe and reliable service for the placement of central venous access devices.
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Australasian radiology · Dec 2006
Clinical TrialCan an evidence-based guideline reduce unnecessary imaging of road trauma patients with cervical spine injury in the emergency department?
The aim of this study was to determine if an unvalidated imaging guideline can reduce the use of imaging in patients with cervical spine trauma. A non-randomized clinical trial using historical controls was conducted in the emergency department from October 2001 to September 2002. Following an education programme, which introduced the imaging guideline to clinicians, the use of guideline and imaging were measured. ⋯ There were no delayed diagnoses of cervical spine injury among those not imaged. It is feasible to disseminate and implement an evidence-based imaging guideline for patients with cervical spine trauma. The use of a computerized decision-support system can facilitate this and is associated with a safe reduction in the proportion of patients imaged.
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Australasian radiology · Oct 2006
Randomized Controlled TrialUse of topical misoprostol to reduce radiation-induced mucositis: results of a randomized, double-blind, placebo-controlled trial.
Radiation-induced mucositis is an acute reaction of the mucosa of patients undergoing head and neck radiotherapy. It can have debilitating and dose-limiting consequences. There is no consensus on an accepted intervention that significantly reduces its severity. ⋯ However, this difference did not translate into a worse feeling of general well-being as measured by a simple visual analogue scale (5.8 vs 5.2; P = 0.3). In conclusion, we were unable to identify a reduction in radiation-induced mucositis in patients receiving misoprostol. There is a paucity of high-level evidence on potentially useful interventions and a continued need for new and innovative research, incorporating quality-of-life measurements, in patients experiencing radiation-induced mucositis.
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Australasian radiology · Oct 2006
Clinical TrialDuration of pneumothorax as a complication of CT-guided lung biopsy.
The purpose of this study was to determine management guidelines for biopsy-induced pneumothorax with the assistance of manual aspiration, mainly based on the duration of complicated pneumothorax. Data from 388 consecutive percutaneous needle lung biopsies were examined. Patients with pneumothorax on postbiopsy chest CT images underwent percutaneous manual aspiration with an 18-G i.v. catheter. ⋯ In cases requiring chest tube, the mean period from biopsy until resolution of the pneumothorax was 6.0 +/- 5.3 days, but was only 2.4 +/- 2.9 days when chest tube placement was not needed. Specifically, time until recovery was short both in those not requiring manual aspiration (2.1 +/- 3.4 days) and in those with a pneumothorax that disappeared completely or almost completely after manual aspiration (1.9 +/- 2.0 days). The almost equally short recovery periods in patients not requiring manual aspiration and those requiring immediate manual aspiration indicates the value of rapid management.
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Australasian radiology · Oct 2006
Pulmonary embolism: accuracy and safety of a negative CT pulmonary angiogram and value of a negative D-dimer assay to exclude CT pulmonary angiogram-detectable pulmonary embolism.
This is a retrospective study to determine the accuracy and safety of a negative CT pulmonary angiogram (CTPA) based on clinical outcome and to determine the usefulness of a negative D-dimer assay before CTPA. A total of 483 patients with a negative CTPA study were followed up for 3 months, with the aim of detecting episodes of venous thromboembolism and mortality. Three hundred and forty-nine patients had an immunochromatographic D-dimer assay called 'Simplify', carried out before a CTPA examination. ⋯ Of those who died, none of the deaths was thought to be as a result of pulmonary embolism (PE). Single-detector helical CT can be used safely as the primary diagnostic test to evaluate PE. Negative Simplify D-dimer assay and low pretest clinical probability exclude CTPA-detectable PE, and a CTPA is unnecessary in this cohort of patients.