Hodgkin disease: contributions of chest CT in the initial staging evaluation

Chest radiographs and chest computed tomography (CT) scans were compared in 203 patients with newly diagnosed Hodgkin disease. The incidence of positive findings was tabulated from six intrathoracic lymph node groups, lung parenchyma, pericardium, pleura, and chest wall. The discordant cases were assessed to determine impact on clinical management. The CT scans provided additional evidence of disease involvement, ranging from 0% to 15% at each of the designated anatomic sites. Treatment was altered in 9.4% of all patients (19 of 203), including 13.8% (nine of 65) of those undergoing radiation therapy alone and 8.2% (ten of 122) of those undergoing combined-modality treatment. We conclude that routine chest CT examinations are valuable in the clinical management of those patients for whom radiation therapy is planned.     

The training of multicompetent allied health professionals using a combined-fields method

With the advent of DRGs, quality and cost have become the chief considerations of care providers and institutional managers; as a result, persons who can perform competently in crossover fields may be more employable and valuable than their single-credentialed counterparts. In academic health centers with more than one health-related school, opportunities exist to combine degree programs that result in educating multicompetent health care providers (MCHCP). In lieu of thinking about interdisciplinary education in the traditional sense, the training of MCHCPs can be achieved by simply combining one or more aspects of their respective curricula. Three methods--intra-, across-, and extra-field combinations--of melding two historically separate fields are described. An example of an across-field combination--the Baylor College of Medicine Physician Assistant/Perfusion Technology Program--is given.     

The use of deep inspiration preceding the valsalva maneuver and rapid expiration in color doppler imaging of the lower extremity veins

Deep inspiration preceding Valsalva maneuver and rapid expiration immediately following it (DIVE) enhance venous blood flow on color Doppler flow imaging (CDI). The effect of DIVE was assessed in 115 consecutive lower extremity examinations. Of these, 95 or 115 (83%) had negative CDI sonograms, and 20 of 115 (17%) had partially (six of 115) or completely (14 of 115) occluding deep vein thrombosis. DIVE enhanced venous blood flow in 68% of the negative cases, resulting in transient venous distention, and/or more complete color filling, and/or greater spectral flow velocities. The 14 cases with completely occluding thrombi showed no response to DIVE. Six cases with partially occluding thrombi showed moderate to mild response to DIVE, with improved color delineation of the residual patent lumen around the thrombus. The authors conclude that DIVE facilitates deep venous CDI, especially when compression cannot be used to augment venous flow.     

How to Optimize Radiological Images Captured from Digital Cameras, Using the Adobe Photoshop 6.0 Program

Over the past decade, the technology that permits images to be digitized and the reduction in the cost of digital equipment allows quick digital transfer of any conventional radiological film. Images then can be transferred to a personal computer, and several software programs are available that can manipulate their digital appearance. In this article, the fundamentals of digital imaging are discussed, as well as the wide variety of optional adjustments that the Adobe Photoshop 6.0 (Adobe Systems, San Jose, CA) program can offer to present radiological images with satisfactory digital imaging quality.