BackgroundWe evaluated the effectiveness of FDG‐PET scans in identifying sites of active disease and assessing response to therapy in patients with Langerhans cell histiocytosis (LCH). Changes in standardized uptake value (SUV) indicated increased or decreased disease activity before changes are evident by plain films or bone scans.MethodsOne hundred and two PET scans for 44 patients (41 children, 3 adults) with biopsy‐proven LCH were compared with 83 corollary imaging modalities and were rated for overall clinical utility: false positive or negative (“inferior”), confirming lesions identified by another imaging modality (“confirmatory”), or showing additional lesions, response to therapy or recurrence of disease activity (“superior”), in comparison to bone scans, MRI, CT or plain films.ResultsFDG‐PET was rated superior in that 90/256 (35%) new, recurrent, or lesions responding to therapy were identified via change in standard uptake value (SUV) before other radiographic changes. PET scans confirmed active LCH in 146/256 (57%). FDG‐PET was superior to bone scans in that 8/23 (34%) lesions, 11/53 (21%) comparisons to lesions found by MRI, 13/64 (20%) CT, and 58/116 (50%) plain films. PET scans confirmed lesions found by: 14/23 (61%) bone scans, 33/53 (62%) MRI, 45/64 (65%) CT, and 54/116 (46%) of plain films.ConclusionsWhole body FDG‐PET scans can detect LCH activity and early response to therapy with greater accuracy than other imaging modalities in patients with LCH lesions in the bones and soft tissues. Whole‐body FDG‐PET scanning is an important and informative study at diagnosis and for following disease course in patients with LCH. Pediatr Blood Cancer 2009;52:97–101. © 2008 Wiley‐Liss, Inc.
African Americans, testing for at least the 25 recommended mutations. Results: A total of 33 CF carriers were identified. The most common mutations detected were ⌬F508, G622D, R117H/7T, and G551D. The G622D allele frequency among African Americans was 0.18%. We did not detect any 3120ϩ1G3 A carriers, although 4 were expected (P Ͻ 0.05). Conclusions: When considering only the 25 recommended CF mutations, 1 in 75 African Americans screened in our laboratories were carriers (within the expected range, given a 69% mutation detection rate). The addition of 2 mutations, G622D and Q98R (incidentally
A unique specimen of unilateral Sprengel's deformity, and contralateral normal pectoral girdle, were studied morphologically and roentgenographically. The cervical spine exhibited multiple abnormalities involving both the vertebral centra as well as the posterior elements (Klippel-Feil abnormality). A small spina bifida involving C5 and C6 was present. Abnormalities of the spinous processes included an articulation with a well-formed omovertebral bone that also articulated with the vertebral (infraspinatus) margin of the scapula. Secondary (presumed epiphyseal) ossification was present in the omovertebral bone at the distal end. The scapula was deformed, especially in the supraspinatus portion. The clavicle was shorter and had a different contour.
OBJECTIVE: Rates of maternal morbidity in the US are accelerating partly due to increasing comorbidities among pregnant women. Proposals to adopt levels of maternal care (LOMC), similar to neonatal care, would direct patients to riskappropriate care earlier in pregnancy, theoretically reducing maternal transports, optimizing resources, and improving outcomes. The objective of this study is to describe characteristics and indications for maternal transport by LOMC within a state transport system. STUDY DESIGN: This is a retrospective cohort study of all maternal transports from Sept '15 e Jun '19 to Johns Hopkins Hospital (JHH, one of two Level IV centers within Maryland) or JH Bayview (JHB, Level III). Data were extracted from transport logs and electronic medical records; transports for neonatal indication were excluded. Continuous variables were compared using ANOVA, categorical variables using Chi-square, and a p-value < 0.05 used for statistical significance. RESULTS: 652 transports for maternal indication were recorded. Transport indication varied significantly by LOMC (P< 0.001): hospitals with 'no L&D' most commonly transported for
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