The aim of this study was to compare the performance of the CT and the water-soluble contrast enema (CE) in the diagnosis and the severity of acute left-colonic diverticulitis, and to recognize the impact of CT during the acute phase and after a first acute episode successfully treated medically. From 1986 to 1997, all patients admitted in our emergency center with clinically suspected left-colonic diverticulitis had a CE and a CT within 72 h of their admission, unless clinical findings required immediate laparotomy. They were prospectively included in the study if one or both radiological exams showed signs of acute diverticulitis and/or diverticulitis was surgically removed and histologically proven. Diverticulitis was considered moderate when CT showed localized thickening of the colonic wall (5 mm or more) and inflammation of pericolic fat and CE showed segmental lumen narrowing and tethered mucosa; it was considered severe when abscess and/or extraluminal air and/or contrast were observed on CT and when one or both of the latter signs were seen on CE. Five hundred forty-two patients entered the study; 465 patients (86%) had a CT exam, 439 (81%) had a CE, and 420 (77%) had both exams. The performance of CT is significantly superior to CE in terms of sensitivity (98 vs 92%, p<0.01), and in the evaluation of the severity of the inflammation (26 vs 9%, p<0.02). Moreover, of 69 patients who had an associated abscess seen on CT, only 20 (29%) had indirect signs of this complication on CE. During the acute phase the chances of medical treatment failure are statistically greater when diverticulitis is considered severe on CT than when it is considered moderate (26% for the severe diverticulitis vs 4% for the moderate ones, p<0.0001). After successful medical treatment of the acute episode, patients with severe diverticulitis on the CT had statistically greater incidence of secondary bad outcome than patients with moderate diverticulitis (36 vs 17%, p<0.0001). Computed tomography should be preferred to CE as the initial radiological exam of diverticulitis because of its statistically significant superiority in sensitivity and for its statistically much higher performance in the detection of severe infection, especially when an abscess is associated with the disease. The severity of diverticulitis on CT is statistically predictive of the risk of medical treatment failure during the acute phase and of the chances of bad secondary outcome after a successful medical treatment of the first episode.

ObjectivesPositron emission tomography-computed tomography (PET/CT) with fluorine-18-fluorodeoxy-D-glucose (FDG) has evolved from a research modality to an invaluable tool in head and neck cancer imaging. However, interpretation of FDG PET/CT studies may be difficult due to the inherently complex anatomical landmarks, certain physiological variants and unusual patterns of high FDG uptake in the head and neck. The purpose of this article is to provide a comprehensive approach to key imaging features and interpretation pitfalls of FDG-PET/CT of the head and neck and how to avoid them.MethodsWe review the pathophysiological mechanisms leading to potentially false-positive and false-negative assessments, and we discuss the complementary use of high-resolution contrast-enhanced head and neck PET/CT (HR HN PET/CT) and additional cross-sectional imaging techniques, including ultrasound (US) and magnetic resonance imaging (MRI).ResultsThe commonly encountered false-positive PET/CT interpretation pitfalls are due to high FDG uptake by physiological causes, benign thyroid nodules, unilateral cranial nerve palsy and increased FDG uptake due to inflammation, recent chemoradiotherapy and surgery. False-negative findings are caused by lesion vicinity to structures with high glucose metabolism, obscuration of FDG uptake by dental hardware, inadequate PET scanner resolution and inherent low FDG-avidity of some tumours.ConclusionsThe interpreting physician must be aware of these unusual patterns of FDG uptake, as well as limitations of PET/CT as a modality, in order to avoid overdiagnosis of benign conditions as malignancy, as well as missing out on actual pathology.Teaching points• Knowledge of key imaging features of physiological and non-physiological FDG uptake is essential for the interpretation of head and neck PET/CT studies.• Precise anatomical evaluation and correlation with contrast-enhanced CT, US or MRI avoid PET/CT misinterpretation.• Awareness of unusual FDG uptake patterns avoids overdiagnosis of benign conditions as malignancy.

Abstract-Sustainability has emerged as a broad concern for society. Many engineering disciplines have been grappling with challenges in how we sustain technical, social and ecological systems. In the software engineering community, for example, maintainability has been a concern for a long time. But too often, these issues are treated in isolation from one another. Misperceptions among practitioners and research communities persist, rooted in a lack of coherent understanding of sustainability, and how it relates to software systems research and practice. This article presents a cross-disciplinary initiative to create a common ground and a point of reference for the global community of research and practice in software and sustainability, to be used for effectively communicating key issues, goals, values and principles of sustainability design for software-intensive systems. The centrepiece of this effort is the Karlskrona Manifesto for Sustainability Design, a vehicle for a much needed conversation about sustainability within and beyond the software community, and an articulation of the fundamental principles underpinning design choices that affect sustainability. We describe the motivation for developing this manifesto, including some considerations of the genre of the manifesto as well as the dynamics of its creation. We illustrate the collaborative reflective writing process and present the current edition of the manifesto itself. We assess immediate implications and applications of the articulated principles, compare these to current practice, and suggest future steps.

The present study indicates that some dancing movements could damage the hip joint, which could lead to early osteoarthritis.

Abstract-The critical role that software plays in society demands a paradigm shift in the mindset of Software Engineering. The focus of this shift begins in Requirements Engineering.

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Model-based iterative reconstruction allows detection of pulmonary nodules with ULD-CT with radiation exposure in the range of a posterior to anterior (PA) and lateral chest X-ray.

Computed tomography is now widely used in the initial diagnostic workup of adult trauma victims with suspected intra-abdominal injuries. We review the role of CT in the detection and management of blunt visceral injuries in two parts. In the first part we discuss general aspects of performing CT in the setting of abdominal trauma and the diagnostic findings of intra-abdominal hemorrhage and blunt hepatic and splenic injuries. Hepatic and splenic injuries can be detected by means of CT with a high accuracy. The vast majority of hepatic injuries can be successfully managed conservatively, even when CT demonstrates parenchymal damage of more than three segments and major hemoperitoneum. Delayed complications, e. g., formation of biloma or a false aneurysm, can be readily detected on repeat CT studies, although they are quite uncommon. The outcome of conservative treatment of splenic injuries remains unpredictable because delayed splenic rupture may occur even when initial CT shows only minor parenchymal lesions and little or no intraperitoneal hemorrhage.