Immunocompromised status keeps on being a challenge for a neurologist, especially in the context of the coronavirus disease-19 (COVID-19) pandemic. We report a clinical case of a human-immunode ciency virus (HIV)-positive patient who developed an acute transverse myelitis. Magnetic Resonance Imaging (MRI) examination showed longitudinally extensive spinal cord abnormality, and laboratory tests con rmed SARS-CoV-2 infection. The patient responded to methylprednisolone pulse therapy and therapeutic plasma exchange. No cases of HIV-positive patients with myelitis and COVID-19 has been reported yet.
De Garengeot's hernia is a rare entity defined as the presence of the appendix within the femoral hernia sac. Although appendicitis is a common surgical emergency, appendix herniation into the groin results in a complex symptoms and signs, which make it difficult to diagnose clinically. We report a case of a 72-year-old male who had De Garengeot's hernia. Ultrasound and contrast-enhanced CT revealed a typical radiological feature of femoral hernia with the appendix herniating within femoral hernia sac. Surgical management of De Garengeot's hernia is controversial, and it is tailored according to the patient clinical situation and surgeon's preference. To the best of our knowledge, this is the first case that combines both CT and ultrasound findings with postoperative findings.
AimCOVID-19 has present the working environment with terms such as volatility, uncertainty, complexity, and ambiguity, which are factors that has the potential to significantly result in the possible breakdown of the workforce as they experience more and more collapse of community, absence of fairness, and conflicting values. This study aimed to measure radiographers' experience during COVID-19 using pandemic experiences & perceptions survey (PEPS) tool. The tool provides critical information on the extent of workflow disruption, the measure and availability of resources, risk perception, impact on working dynamics (workload, control, reward, community, fairness, and values) and management.Methods:An online survey was distributed from May 2020 to June 2020 to radiographers who work in Kuwait government, private hospitals, clinics, or newly authorized medical quarantine centers. The survey consists of 2 pages, 34 questions in total, with an additional added demographic page. In total, it takes 10 to 15 minutes to complete the survey. For reporting PEPS results, we used descriptive analysis for the demographic data, average scoring, and mean and standard deviation (SD) for the tool items.Results:The number of participants who attempted to answer the survey was 347; however, only 102 participants completed the survey. 48 (47.1%) males and 54 (52.9%) females, the questionnaire had a mean (± SD) age of (35.7 ± 8.2) years. 89% of participants have indicated that they have been in direct contact with COVID-19. 57.8% have expressed that they have had the training, support, and equipment to provide minimal control over the virus. Furthermore, more than half of the participants (68.7%) have expressed fear of the virus and that the virus presented a danger to them. With regards to the five PEPS tools, the mean ± SD (table 1) were: Disruption 2.487 (±1.094), resources 2.580 (±1.196), risk perception 2.963 (±1.713), impact on work-life areas 3.810 (±0.992), and Leadership 3.795 (±0.965).Conclusion:The majority of radiographers explained fear and risk of working with COVID-19; however, they had a positive attitude toward their leadership and management. Most radiographers explained that regardless of their faith in management, additional education interventions and campaigns were required to improve their sense of safety and confidence. Working with an insensitive working environment of COVID-19, any organization will experience some burnout, depending on both the quality of the management system and how leaders react in real-time. This PEPS tool can help to contain future burnouts and conflicts.
Purpose: This work investigated the behaviour of a high-field MR system relative to a range of pulse sequence parameter changes and image artefacts resulting from image acquisition employing an Echo-Planar Diffusion-Weighted (EPI-DW) sequence modified for musculoskeletal imaging of the Achilles Tendon (AT). Methods and Materials: MR scanning was undertaken on a 3T Philips Achieva MR scanner with an 8-channel foot/ ankle coil. Image quality evaluation was based on images acquired using two phantoms: 1) an L-shaped foot/ ankle phantom containing Nickel Chloride (NiCl2) in water and 2) a small cylindrical plastic phantom containing copper sulphate (CuSO4) in water. Quality control (QC) measurements were based on the American College of Radiology (ACR) specifications. Signal-to-noise ratio (SNR), image intensity uniformity, percentage ghosting, and geometric distortion were measured for phantom images acquired using four sequences (T1W SE, T2W TSE, STIR, EPI-DW). Results: The performance of the EPI-DW sequence was tested according to ACR specifications and compared to three standard pulse sequences routinely used for scanning of the AT. The EPI-DW sequence met the ACR criteria for SNR and image intensity uniformity, but failed to meet geometric distortion criteria. In terms of percentage ghosting, artefacts were evident in the EPI-DW and ADC map images. However, when quantified, these images remained within ACR specifications for image ghosting. Conclusion: When modifying a pulse sequence for a new application, it is essential to understand in advance the technical performance characteristics of the MR system and their potential impact on resultant MR image quality. This study demonstrated that the results of image quality testing revealed important findings that facilitated further optimisation of the EPI-DW sequence prior to its application for Achilles tendon scanning in human subjects.
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