Approximately 10% of all significant blunt abdominal traumatic injuries manifest with renal injury, although it is usually minor. However, renal imaging is indicated in cases of gross hematuria, penetrating trauma with gross or microscopic hematuria, and blunt trauma and shock with gross or microscopic hematuria. Contrast material-enhanced computed tomography (CT) is the imaging modality of choice in the evaluation and management of renal trauma. Contrast-enhanced CT is readily available in emergency departments and can quickly and accurately depict renal injuries as well as associated injuries to other abdominal or retroperitoneal organs. In this way, contrast-enhanced CT provides the anatomic and functional information that is essential for accurate staging. In addition, CT can help detect active hemorrhage and urinary extravasation and is very useful in guiding transcatheter embolization and delineating preexisting disease entities that may predispose kidneys to posttraumatic hemorrhage. With the advent of multidetector CT, imaging is characterized by faster scanning times, increased volume coverage, and improved spatial and temporal resolution. The increased use of CT has been partially responsible for a growing trend toward conservative management of renal trauma, except in cases in which extensive urinary extravasation or devitalized areas of renal parenchyma are found and especially in those cases with associated injuries to other abdominal organs; these cases are particularly prone to complications and usually require surgery.

The purpose of this study is to highlight the role of multidetector CT (MDCT) in emergency radiology as a useful tool in the diagnosis and management of acute female pelvic disease and to describe key radiologic signs to improve differential diagnosis. We restrospectively reviewed MDCT findings of acute pelvic disease and its mimics in women reporting to the emergency room at our institution from December 2006 to August 2008. We describe MDCT findings of gynecologic and obstetric disorders such as hemorrhagic ovarian cysts, ovarian torsion, pelvic inflammatory disease, ruptured ectopic pregnancy, intravascular leiomyomatosis, blunt maternal trauma, and postpartum and post-cesarean section complications. We also briefly review gastrointestinal tract entities that may mimic these conditions. Although ultrasound is the imaging modality of choice for the evaluation of female pelvic pain, the role of MDCT remains essential in the management of patients in which gynecologic exploration is not diagnostic or undone since it is not the initial suspicion.

PurposeMetallic artifacts can result in an artificial thickening of the coronary stent wall which can significantly impair computed tomography (CT) imaging in patients with coronary stents. The objective of this study is to assess in vivo visualization of coronary stent wall and lumen with an edge-enhancing CT reconstruction kernel, as compared to a standard kernel.MethodsThis is a prospective cross-sectional study involving the assessment of 71 coronary stents (24 patients), with blinded observers. After 256-slice CT angiography, image reconstruction was done with medium-smooth and edge-enhancing kernels. Stent wall thickness was measured with both orthogonal and circumference methods, averaging thickness from diameter and circumference measurements, respectively. Image quality was assessed quantitatively using objective parameters (noise, signal to noise (SNR) and contrast to noise (CNR) ratios), as well as visually using a 5-point Likert scale.ResultsStent wall thickness was decreased with the edge-enhancing kernel in comparison to the standard kernel, either with the orthogonal (0.97 ± 0.02 versus 1.09 ± 0.03 mm, respectively; p<0.001) or the circumference method (1.13 ± 0.02 versus 1.21 ± 0.02 mm, respectively; p = 0.001). The edge-enhancing kernel generated less overestimation from nominal thickness compared to the standard kernel, both with the orthogonal (0.89 ± 0.19 versus 1.00 ± 0.26 mm, respectively; p<0.001) and the circumference (1.06 ± 0.26 versus 1.13 ± 0.31 mm, respectively; p = 0.005) methods. The edge-enhancing kernel was associated with lower SNR and CNR, as well as higher background noise (all p < 0.001), in comparison to the medium-smooth kernel. Stent visual scores were higher with the edge-enhancing kernel (p<0.001).ConclusionIn vivo 256-slice CT assessment of coronary stents shows that the edge-enhancing CT reconstruction kernel generates thinner stent walls, less overestimation from nominal thickness, and better image quality scores than the standard kernel.

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These data support the proposal that e-mail and text-messaging e-health tools are likely to be immediately adopted by eye clinic patients and therefore have the greatest potential to improve health outcomes and increase quality of care. Eye clinic patients are interested in these technologies for appointment reminders, general eye and vision health information, asking urgent medical questions, and requesting prescription refills. Future controlled trials could further explore the efficacy of e-health tools for these purposes.

Improved durability of concrete is mainly achieved with low-permeability. Permeability depends on permeability of the bulk cement paste (CP) and that of its interfacial transition zone (ITZ). Even though permeability of CP is well understood and can be adequately controlled, permeability of ITZ is not well understood yet. This paper shows that minimizing permeability of concrete requires minimizing permeability of CP by using a supplementary cementing material (SCM) such as natural pozzolans (NP) and minimizing ITZ by reducing aggregate content until maximum cement content. This was done by comparing performance of concrete made with ordinary Portland cement (OPC) and blended cement (OPC+NP) at the same w/b, and by comparing performance of concrete with different amount of ITZ at the same w/b. All of this was performed through testing of mechanical properties, air permeability, sorptivity, chloride ion diffusion, and aggregate specific surface. Results show that NP reduced air permeability by 84% and chloride ion diffusion by 66%, but increased sorptivity up to 140%. ITZ has an important effect in all properties; especially in air permeability where sensitive reduction of more than a 90% was achieved. ITZ effect seems to be as important as using SCMs in improving durability of concrete.

PurposeThe objective of this study is to assess the effect of heart rate, heart rate variability and z-axis location on coronary artery bypass graft (CABG) image quality using a 256-slice computed tomography (CT) scanner.MethodsA total of 78 patients with 254 CABG (762 graft segments) were recruited to undergo CABG assessment with 256-slice CT and prospective ECG-gating. Two observers rated graft segments for image quality on a 5-point scale. Quantitative measurements were also made. Logistic and cumulative link mixed models were used to assess the predictors of graft image quality.ResultsGraft image quality was judged as diagnostic (scores 5 (excellent), 4 (good) and 3 (moderate)) in 96.6% of the 762 segments. Interobserver agreement was excellent (kappa ≥0.90). Graft image quality was not affected by heart rate level. However, high heart rate variability was associated with an important and significant image quality deterioration (odds ratio 4.31; p  =  0.036). Distal graft segments had significantly lower image quality scores than proximal segments (p ≤ 0.02). Significantly higher noise was noted at the origin of the mammary grafts (p  =  0.001), owing to streak artifacts from the shoulders.ConclusionCABG imaging with 270-msec rotation 256-slice CT and prospective ECG-gating showed an adequate image quality in 96.6% of graft segments, and an excellent interobserver agreement. Graft image quality was not influenced by heart rate level. Image quality scores were however significantly decreased in patients with high heart rate variability, as well as in distal graft segments, which are closer to the heart.

En Chile, la acción habitacional presenta soluciones de viviendas sociales que responden sólo a factores cuantitativos, debido a la necesidad de reducir el déficit habitacional del país, dejando en un segundo plano los factores cualitativos que otorgan las condiciones de habitabilidad y confort dentro de las viviendas. Entre los factores cualitativos se enmarcan aspectos como aislación térmica, ventilación, control de humedad y del vapor interior, asoleamiento, por mencionar algunos, que afectan la calidad de vida de los moradores. En este contexto se planteó la presente investigación cuyo objetivo principal fue determinar los factores que afectan el bienestar de las personas en el interior de las viviendas sociales, evaluando el fenómeno de condensación. Para lograr los objetivos de la investigación, se realizó en primera instancia un estudio teórico del problema y del fenómeno de condensación que se produce en las viviendas sociales, luego se realizó una evaluación del comportamiento de las viviendas mediante mediciones en terreno y aplicación de encuestas a los habitantes. Posteriormente se analizaron los datos, se obtuvieron las conclusiones y se propusieron mecanismos de acción. La investigación permitió concluir que el fenómeno de condensación es un problema recurrente en las viviendas sociales, y que las causas principales son la alta humedad relativa del aire ambiente interior, debido a los malos hábitos de los usuarios, y las bajas temperaturas superficiales de muros y cielos con respecto a la temperatura de aire interior.