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Enhance Your Veterinary Dentistry Skills! Apply to the Veterinary Dental Practitioner Program for specialized training today! https://ivdi.org/inv Explore Dr. Beckman's courses and resources to deepen your expertise in veterinary dentistry. https://veterinarydentistry.net/ Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, answers key questions on veterinary dentistry, including the longevity of crowns, success rates of vital pulp therapy, and when to refer for root canal treatment. What You'll Learn in This Episode: How long crowns last in veterinary patients and if they need replacement Success rates of vital pulp therapy and why early intervention matters Key radiographic signs that indicate the need for a root canal referral Why root canal training isn't available for general practitioners How to educate clients on tooth extractions—even when pets seem fine What to expect in post-root canal monitoring for long-term success Why fractured deciduous teeth in puppies should be extracted ASAP Key Takeaways: Properly placed crowns should last the lifetime of the patient Vital pulp therapy success rates drop significantly after 48 hours Radiographs are essential for determining tooth vitality and referral timing Root canals require extensive training, making referral the best option Client education is critical for gaining owner compliance with extractions Fractured baby teeth can lead to infection and should be extracted immediately Links & Resources for Veterinary Professionals: Apply to the Veterinary Dental Practitioner Program - https://ivdi.org/inv Explore Dr. Beckman's courses and resources - https://veterinarydentistry.net/ Have questions or comments? Let us know below, and don't forget to like, subscribe, and turn on notifications for more valuable veterinary dentistry content!
In today's episode, we will be looking at the radiographic assessment and biomechanics interpretation of mechanism of injury for several different types of injury. Today, we will be looking primarily at fracture and dislocation in the upper cervical region.
In this episode, Dr. Jonathan Revels unpacks essential chest radiograph signs, providing practical insights and tips for mastering chest imaging interpretation. Classic Signs on Chest Radiographs:Primer for Residents. Ufuk et al. RadioGraphics 2025; 45(2):e240155.
What has more radiation, bananas or dental x-rays? Here's an interesting way to explain how much radiation patients are exposed to during dental x-rays. Lauren Godshall, RDH Read by Jackie Sanders https://www.rdhmag.com/patient-care/radiology/article/55237562/bananas-versus-dental-radiographs-which-has-more-radiation
Alan welcomes back Dr. Melissa Seibert to talk about caries removal. While academics and researchers don't find the idea of incomplete caries removal controversial, many clinicians just can't get their head around it! Melissa drops a LOT of knowledge on us in this episode! Key takeaways: Selective caries removal is a well-substantiated approach to caries management that involves removing only the infected dentin while leaving affected dentin behind. This can help to preserve healthy tooth structure and avoid pulpal exposure. Magnification and light are essential for accurate caries diagnosis. Melissa emphasizes the importance of "sharp eyes and a dull explorer." Radiographs are crucial for monitoring caries progression and making informed decisions about treatment. SDF can be a valuable tool for arresting caries in both children and adults. Sealants, especially glass ionomer sealants, can be effective in preventing caries, but proper isolation is essential. The sandwich technique is an older technique that is not as commonly used today. Vital pulp therapy is a topic that will be explored in a future episode. Some links from the show: Elevated GP: theelevatedgp.com - Melissa's website with on-demand dental content and a journal club. Bioclear GC Fuji Triage Episode Index: 02:02 The Birth of Elevated GP 05:28 Selective Caries Removal Debate 08:31 Approaches to Caries Removal 14:35 The Importance of Magnification and Light 21:23 Exploring Conservative Options: SDF in Adults 21:49 Challenges and Considerations with SDF 23:00 Sealants: Best Practices and Controversies 27:25 Selective Caries Removal: Techniques and Opinions 29:58 Bonding and Margins: Ensuring Success 37:25 The Role of Silver Diamine Fluoride in Caries Excavation Join the Very Dental Facebook group using the password "Timmerman," Hornbrook" or "McWethy," "Papa Randy" or "Lipscomb!" The Very Dental Podcast network is and will remain free to download. If you'd like to support the shows you love at Very Dental then show a little love to the people that support us! -- Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code “VERYDENTAL10” you'll get another 10% off your order! Go save yourself some money and support the show all at the same time! -- The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! -- Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! -- CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!
Welcome to the 11th EPISODE of the BSCOS Paediatric Orthopaedic Digest (POD)cast & our 3rd festive episode we have invited more orthopaedic royalty: Professor Tim Theologis! Although recently retired from the Nuffield Orthopaedic Centre in Oxford, he continues to be heavily involved in academic research especially in children with cerebral palsy. He is principal investigator for a number of multi-centre randomised control trials including CPinBOSS, PICBONE, SPELL, ROBUST and is working on developing outcome measures for elective lower limb surgery in children. As past president of BSCOS we all learnt so much from his wisdom, his drive to continue understanding in our field, and supporting the next generation of surgeons. Listen in to the episode to learn more! We scoured 35 journals & highlighted the most impactful studies that we feel can change practice or improve outcomes in Paediatric Orthopaedics. Follow Updates on @BSCOS_UK REFERENCES: 1. Factor analysis of the Gait Outcomes Assessment List's goal questions: A new method to measure goal prioritization in ambulatory individuals with cerebral palsy. Munger ME et al. Dev Med Child Neurol. June 2024. PMID: 37431682. 2. Oral versus intravenous empirical antibiotics in children and adolescents with uncomplicated bone and joint infections: a nationwide, randomised, controlled, non-inferiority trial in Denmark. Nielsen et al. Lancet Child Adolesc Health. July 2024. PMID: 39025092 3. Knee Pain, Joint Loading, and Structural Abnormalities on MRI in 13-Year-Old Children in a Population-Based Birth Cohort. Van Leeuwen et al. Am J Sports Med. Sept 2024. PMID: 39320429 4. Adherence to Wide-Abduction Brace Treatment is Associated With Improved Hip Abduction and Radiographic Outcomes in Legg-Calvé-Perthes Disease. Parasadh et al. J Pediatr Orthop. Nov-Dec 2024. PMID: 39187945 5. Effect of Mindfulness Training on Skill Performance in Simulator-Based Knee Arthroscopy Training for Novice Residents-A Randomized Controlled Study. Li W et al. J Surg Educ. Dec 2024. PMID: 39471565 6. Is there a place for dorsal hemiepiphysiodesis of the first metatarsal in the treatment of pes cavovarus? Domingues et al. J Pediatr Orthop B. Sept 2024. PMID: 39302844 7. Closed Reduction Techniques Are Associated With Fewer Complications Than Open Reductions in Treating Moderately Displaced Pediatric Lateral Humeral Condyle Fractures: A Multicenter Study.Tippabhatla et al. J Pediatr Orthop. Nov-Dec 2024. PMID: 39021076. 8. Understanding the mechanism of injury and fracture pattern of paediatric triplane ankle fractures versus adult trimalleolar fractures. Prijs et al. Bone Joint J. Sept 2024. PMID: 39216867. 9. Staples, tension-band plates, and percutaneous epiphysiodesis screws used for leg-length discrepancy treatment: a systematic review and proportional meta-analysis. Tirta et al. Acta Orthop. July 2024. PMID: 39023429 10. Efficacy of a Multimodal Surgical Site Injection for Postoperative Pain Control in Pediatric Patients With Cerebral Palsy Undergoing Hip Reconstruction: A Randomized Controlled Trial. Greig et al. J Pediatr Orthop. Nov-Dec 2024. PMID: 39140418. 11. The Prevalence of Hip Dysplasia on Radiographs for Adolescent Idiopathic Scoliosis. Fowler et al. J Pediatr Orthop. Sept 2024. PMID: 38826034. 12. Education, Language, and Cultural Concordance Influence Patient-Physician Communication in Orthopaedics. Diaz et al. J Bone Joint Surg Am. June 2024. PMID: 38941477. Follow Hosts: @AnishPSangh @AlpsKothari @Pranai_B Have a Merry Christmas and Festive Period with your loved ones!
Understanding and Addressing Patient Concerns Regarding Dental Radiographs By Zehra Chowdhury, RDH, BSc, BS, PG Cert Original article published on Today's RDH: https://www.todaysrdh.com/understanding-and-addressing-patient-concerns-regarding-dental-radiographs/ Need CE? Start earning CE credits today at https://rdh.tv/ce Get daily dental hygiene articles at https://www.todaysrdh.com Follow Today's RDH on Facebook: https://www.facebook.com/TodaysRDH/ Follow Kara RDH on Facebook: https://www.facebook.com/DentalHygieneKaraRDH/ Follow Kara RDH on Instagram: https://www.instagram.com/kara_rdh/
What's the difference between radiolucency and burnout? When's the best time to use a bitewing vs a periapical radiograph? When should we pick up the bur for interproximal caries? Have you heard about the 4 white lines an OPG radiograph? https://youtu.be/wCV3U8-OAvI Watch PS011 on Youtube This episode is packed full of great tips and techniques that will help you understand how to produce great radiographs as well as being able to properly figure out what they are trying to tell us. Radiographs can be tricky, whether that's due to them being flipped, upside down or due to cone cut, that's why this will help shine some light on how to get comfortable with radiographs as well as how to manage our patients after we know what we are dealing with. Don't miss the special notes on Radiology and Radiography for Students available exclusively in the Protrusive Guidance app! (Join the free Students Section) This episode is not eligible for CPD/CE points, but never fear, there are hundreds of hours of CPD for Dentists waiting for you on the Protrusive App! For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. If you love this episode, check out PS003 - Routine Checkup
The Evidence Based Chiropractor- Chiropractic Marketing and Research
Today, we unravel whether radiographic features predict long-term back pain in older adults. Can X-rays tell the future of back pain? Low back pain is a significant reason why people visit chiropractors. Up to 80% of adults will experience it at some point, and around 30% are now dealing with it.Understanding predictive factors for long-term back pain helps set accurate patient expectations and improve outcomes. This study focused on spinal osteoarthritis in older adults and its role in predicting persistent and severe back pain after one year. Researchers analyzed spinal stiffness, range of motion, and radiographic features like osteophytes and disc space narrowing in over 500 adults. Over 60% had back pain one year later. Episode Notes: Clinical and radiographic features of spinal osteoarthritis predict long-term persistence and severity of back pain in older adultsJane is an online platform for health and wellness practitioners that makes it simple to book, chart, schedule, bill, and get paid. I you're ready to get started, click here and use the code EBC1MO for a 1-month grace period on your new account.The Best Objective Assessment of the Cervical Spine- Provide reliable assessments and exercises for Neuromuscular Control, Proprioception, Range of Motion, and Sensorimotor-Integration. Learn more at NeckCare.comInterested in ShockWave technology? I built a practice using StemWave and can't recommend it enough. Learn more at- https://gostemwave.com/theevidencebasedchiropractor Patient Pilot by The Smart Chiropractor is the fastest, easiest to generate weekly patient reactivations on autopilot…without spending any money on advertising. Click here to schedule a call with our team.Our members use research to GROW their practice. Are you interested in increasing your referrals? Discover the best chiropractic marketing you aren't currently using right here!
Summary In this episode of the Vet Dental Show, Dr. Brett Beckman, Board Certified Veterinary Dentist, interviews Dr. Trudy Bowden, a long-time friend, colleague, and accomplished veterinary dental practitioner. Dr. Bowden shares her inspiring journey from rekindling her passion for dentistry to becoming a key player in her practice's dental services. They discuss overcoming challenges, the importance of continuous learning, and the rewarding nature of veterinary dentistry. Tune in for an insightful conversation filled with practical tips and motivational stories. Guest, Cast, and Crew Information Host: Dr. Brett Beckman, Board Certified Veterinary Dentist Guest: Dr. Trudy Bowden, Veterinary Dental Practitioner Sponsor: Veterinary Dental Practitioner Program Main Talking Points Introduction: Overview of the episode and sponsorship details. Guest Introduction: Dr. Trudy Bowden's background and journey in veterinary dentistry. Initial Challenges: Overcoming the initial lack of confidence and building skills. Impact of Dental Radiographs: The transformative effect of implementing dental x-rays in practice. Professional Growth: Continuous learning through courses and mentorship. Balancing Life and Career: Managing professional growth while raising a family. Health Scare and Reassessment: Reprioritising life and career goals after a health scare. Importance of Passion and Purpose: Finding and pursuing a passion for dentistry. Transition to a New Practice: Moving from a lead role in a small practice to a learner in a larger hospital. Teaching and Mentoring: The rewards of teaching and continued learning. Interesting Quotes "What would you do if you weren't afraid? I want to do dentistry full time." "We knew we were missing pathology, we just didn't know how much we were missing." "The return on investment professionally and personally is just without compare." Timestamps 00:00 - 00:30: Introduction 00:31 - 01:30: Guest Introduction - Dr. Trudy Bowden 01:31 - 03:00: Overcoming Initial Challenges 03:01 - 04:30: Implementing Dental Radiographs 04:31 - 06:00: Continuous Learning and Professional Growth 06:01 - 08:00: Balancing Life and Career 08:01 - 09:30: Health Scare and Reassessment 09:31 - 11:00: Importance of Passion and Purpose 11:01 - 12:30: Transition to a New Practice 12:31 - 13:00: Teaching and Mentoring [Veterinary dentistry, dental radiographs, professional growth, veterinary dental practitioner, balancing life and career, passion in veterinary practice, continuous learning, teaching and mentoring, Dr. Brett Beckman, Dr. Trudy Bowden] Key Points Summary Introduction: Welcoming listeners and introducing the guest, Dr. Trudy Bowden. Guest Background: Dr. Bowden's educational background and journey in veterinary dentistry. Initial Challenges: Building confidence and skills through courses and mentorship. Dental Radiographs: The significant impact of introducing dental x-rays in her practice. Professional Growth: Continuous learning through seminars and mentorship programs. Balancing Life: Managing a professional career while raising a family. Health Reassessment: Reprioritising goals after a health scare. Passion and Purpose: The importance of finding and pursuing a passion for dentistry. Transition: Moving to a larger hospital and continuing to learn and teach. Teaching: The rewards and challenges of teaching and mentoring others. Affiliate & Sponsor Links IVDI.org/INV - Submit your request for an invitation to the Veterinary Dental Practitioner Program
Summary In this episode of the Vet Dental Show, Dr. Brett Beckman, Board Certified Veterinary Dentist, answers listener questions about managing gingival hyperplasia in boxers and other brachycephalic breeds. Dr. Beckman discusses the importance of radiographs before treatment, when to refer complex cases, and the nuances of dealing with epulides. Tune in for expert advice and practical tips to enhance your veterinary dental practice. Guest, Cast, and Crew Information Host: Dr. Brett Beckman, Board Certified Veterinary Dentist Sponsor: Veterinary Dental Practitioner Program Main Talking Points Introduction: Overview of the episode and sponsorship details. Listener Question: Mandy's question on treating gingival hyperplasia in boxers. Radiographs Importance: The necessity of taking radiographs before treatment. Treatment Approach: Steps to handle gingival hyperplasia and epulides. When to Refer: Guidance on referring complex brachycephalic cases. Histopathology: The importance of submitting tissue for histopathology. Maintenance and Follow-Up: Managing recurrent gingival hyperplasia. Interesting Quotes "You do not want to go in and start removing tissue without first taking radiographs." "Brachycephalic breeds often have dense cortical bone, making extractions more challenging." "Gingival hyperplasia will come back and requires maintenance every 6 to 18 months." Timestamps 00:00 - 00:30: Introduction 00:31 - 02:00: Listener Question from Mandy 02:01 - 04:00: Importance of Radiographs 04:01 - 06:00: Treatment Approach for Gingival Hyperplasia 06:01 - 08:00: When to Refer Complex Cases 08:01 - 10:00: Histopathology and Tissue Submission 10:01 - 11:30: Maintenance and Follow-Up 11:31 - 13:00: Summary and Conclusion [Veterinary dentistry, gingival hyperplasia, brachycephalic breeds, radiographs, dental extractions, epulides, histopathology, veterinary dental training, Dr. Brett Beckman] Key Points Summary Radiographs Importance: Always take full mouth radiographs before treating gingival hyperplasia. Treatment Approach: Remove affected teeth and contour tissue for closure. Referral Guidance: Refer complex brachycephalic cases to specialists. Histopathology: Submit all excised tissue for pathology to ensure an accurate diagnosis. Maintenance: Regular follow-up and maintenance are necessary for managing recurrent gingival hyperplasia. Affiliate & Sponsor Links IVDI.org/inv - Submit your request for an invitation to the Veterinary Dental Practitioner Program.
Get ahead with VETAHEAD and join Dr. Proença on 15 minutes of ZooMed (exotic animal medicine) content. Today, let's explore the effectiveness of intramuscular alfaxalone for sedating companion rats during thoracic radiographic positioning! This episode delves into the fascinating study on alfaxalone, a sedative that promises smoother, stress-free imaging for our furry patients. Learn about the dosages, effects, and practical applications of this sedative in clinical practice. Whether you're a seasoned vet or just getting started in ZooMed (exotic animal medicine), this episode is packed with valuable insights to enhance your skills and improve patient care. Do you want to access more ZooMed (exotics) knowledge directly from specialists? Come with us and #jointhemovement #nospeciesleftbehind Head to VETAHEAD Website Join our VETAHEAD Community Follow @the_vetahead on Instagram Subscribe to @vetahead channel on YouTube Follow @vetahead on Facebook Follow @vetahead on TikTok
Send us an inquiry through a text message here!Welcome to another episode of The Veterinary Roundtable! This episode the ladies discuss their experience with shelter medicine, if our vet tech staff would create another podcast, recommendations for low cost vet assistant programs, and more!Do you have a question or inquiry for The Veterinary Roundtable? Send us a text from the link above, ask us on any social media platform, or email harrison@kingmediamarketing.com!Episodes of The Veterinary Roundtable are on all podcast services along with video form on YouTube!Instagram: https://tinyurl.com/2h27xnfuTikTok: https://tinyurl.com/m8f62ameTIMESTAMPSIntro 00:00Pits & Peaks 06:10Our Experience With Shelter Medicine (@Desrae) 17:42Groomers Calling Clinics For Issues 21:50Would Our Tech Staff Create A Vet Tech Podcast? 24:04Recommendations For Low Cost Vet Assistant Programs 25:14Ad 26:50Case Collections 27:20Listener Question 30:48Outro 38:10
Kelly a 30-year-old marathon runner presents with a gradual onset of persistent pain at the base of the first metatarsal, which intensifies during long runs and eases with rest. Examination reveals localized swelling, tenderness on palpation, and pain during passive extension of the big toe. Radiographs show no fractures but a slight increase in the space between the first and second metatarsal bones. What is the MOST likely diagnosis? A) Turf toe B) Sesamoiditis C) Hallux valgus D) Metatarsalgia LINKS MENTIONED: NPTE Tips & Tricks: www.nptegroup.com Practice Question Club: www.npteclub.com --- Support this podcast: https://podcasters.spotify.com/pod/show/thepthustle/support
Dr. Todd Blumberg from Seattle Children's joins the show to discuss his recent research proving the importance of careful patient positioning while obtaining a hip ultrasound in a Pavlik Harness. This episode also covers recent research on intra-op imaging after reducing a dislocated hip, screening scoliosis patients for hip dysplasia, and more. Your hosts are Carter Clement from Children's Hospital of New Orleans, Josh Holt from University of Iowa, and Craig Louer from Vanderbilt. Music by A. A. Aalto. References: 1) Standardized in-harness Ultrasound Protocol Improves Success Rate of Brace Treatment for Dislocated Hips. Pargas-Colina et al. JPO 2024. PMID: 38647138. 2) Epidemiology of Pediatric Dog Walking-Related Injuries Among Children Presenting to US Emergency Departments, 2001 to 2020. Maxson et al. JPO 2024. PMID: 38899976. 3) Adolescent Athletes with Stronger Athletic Identity Perceptions Have Weaker Fear Avoidance Perceptions During Musculoskeletal Injury Rehabilitation Return to Sports Preparation. Ferman et al. JPO 2024. 38767118. 4) The Prevalence of Hip Dysplasia on Radiographs for Adolescent Idiopathic Scoliosis. Fowler et al. JPO 2024. 38826034. 5) Intraoperative 3D Fluoroscopy During Open Reduction for DDH: An Effective Alternative to Postoperative CT/MRI. Baljoun et al. JPO 2024. 38779959.
In this episode, Elizabeth Acutt, BSc, BVSc, MS, Dipl. ACVR-EDI, discussed taking radiographs in the field. She discussed some of the challenges of acquiring quality radiographs in the field compared to a clinic environment, talked about equipment choices, and provided tips for radiographing tricky parts of the horse.The Disease Du Jour podcast is brought to you by Merck Animal Health.Disease Du Jour Podcast Hosts, Guests, and Links Episode 137:Host: Carly Sisson (Digital Content Manager) of EquiManagement | Email Carly (CSisson@equinenetwork.com) Guest: Elizabeth Acutt, BSc, BVSc, MS, Dipl. ACVR-EDIPodcast Website: Disease Du JourThe Disease Du Jour podcast is brought to you in 2024 by Merck Animal Health.
In this episode, Elizabeth Acutt, BSc, BVSc, MS, Dipl. ACVR-EDI, discussed taking radiographs in the field. She discussed some of the challenges of acquiring quality radiographs in the field compared to a clinic environment, talked about equipment choices, and provided tips for radiographing tricky parts of the horse.The Disease Du Jour podcast is brought to you by Merck Animal Health.Disease Du Jour Podcast Hosts, Guests, and Links Episode 137:Host: Carly Sisson (Digital Content Manager) of EquiManagement | Email Carly (CSisson@equinenetwork.com) Guest: Elizabeth Acutt, BSc, BVSc, MS, Dipl. ACVR-EDIPodcast Website: Disease Du JourThe Disease Du Jour podcast is brought to you in 2024 by Merck Animal Health.
Dr. Antoni Chan interviews Dr. Thomas Hugle about abstract OP0112 presented at Eular 2024 in Vienna, Austria.
Get ahead with VETAHEAD and join Dr. Proença on 15 minutes of ZooMed (exotic animal medicine) content. Today, let's compare the effectiveness of CT scans and radiographs in diagnosing dental disease in rabbits. Do we need to really to CT, or can we just take x-rays? Discover the latest insights and tips for veterinary professionals looking to enhance their rabbit dental care practices. This episode is packed with valuable information to elevate your expertise in rabbit dental diagnostics! Do you want to access more ZooMed (exotics) knowledge directly from specialists? Come with us and #jointhemovement #nospeciesleftbehind Head to VETAHEAD Website Join our VETAHEAD Community Follow @the_vetahead on Instagram Subscribe to @vetahead channel on YouTube Follow @vetahead on Facebook
Embark on a vibrant and captivating journey with Dr. Josiah Dame and Dr. Natalie Keith as they delve deeper into the captivating world of veterinary medicine. In this episode of Vet Tales, discover engaging veterinary practices' everyday stories while exploring the nuances of medical imaging in animal healthcare. Understand the world of veterinary imaging, and its significance in advanced imaging techniques such as x-rays, ultrasounds, CT scans and MRI. Learn about common anomalies in pets, from orthopedic issues to obstructions in the abdomen and diseases in the chest, and the critical role of medical imaging tools for the process of diagnosis. This episode is more than just informative; it's an engaging narrative peppered with fascinating stories and comic references. Join us as we shed light on the fast-paced, digital realm of veterinary medicine and explore the classic usage of barium and its importance in diagnosing and treating obstructions. Furthermore, delve into real-life situations, like identifying leash ingestion in a bulldog or bladder stones in a schnauzer, through imaging techniques. Discover the irreplaceable role of imaging in animal healthcare and the importance of regular check-ups and non-invasive diagnostic tools for animals' well-being. Finally, the world of canine cardiology is discussed with an in-depth look at how ultrasounds and radiographs help in understanding heart conditions and various other ailments in pets. Experience the fascinating case of Lulu, a dog diagnosed with immune-mediated meningitis, emphasizing the importance of timely and accurate diagnosis. "Vet Tales: Understanding Radiographs, Ultrasound, CT and MRI" is an eye-opening exploration of advanced imaging in veterinary medicine, representing an invaluable resource for pet caretakers, enthusiasts and individuals seeking to understand more about animal health.
Welcome to another episode of The Veterinary Roundtable! In this episode, the ladies answer what they'd replace the handshake with, Dr. King gives an update on her pleural effusion case, a question all the way from Scotland makes an appearance, and more!Do you have a question for The Veterinary Roundtable? Ask us on any social media platform or email harrison@kingmediamarketing.com!Episodes of The Veterinary Roundtable are on all podcast services along with video form on YouTube!Social Links: https://linktr.ee/allstarvetclinicTIMESTAMPSIntro 00:00Icebreakers 07:50Courtney's Case 12:05Devyn's Case 18:00Dr. King's Case 21:20Dr. Duckwall's Case 25:14Listener Question (@Michelle Cicalese) 29:34Outro 38:30
Dental radiographs are used to determine the age of migrant children, but they may not be the best option. Claire Braaten, associate professor of criminology at Texas A&M University-San Antonio, details why. Claire Nolasco Braaten is an associate professor of criminology at Texas A&M University-San Antonio. She obtained her Ph.D. in Criminal Justice from Sam […]
Five articles from the December 2023 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are, “Using 3D MRI Bone Shape to Predict Pre-Osteoarthritis of the Knee 2 Years After Anterior Cruciate Ligament Reconstruction,” “Patellar Dislocation in Adolescent Patients: Influence on Cartilage Properties Based on T1ρ Relaxation Times,” “The Posterior Tibial Slope Is Not Associated With Graft Failure and Functional Outcomes After Anatomic Primary Isolated Anterior Cruciate Ligament Reconstruction,” “Soft Tissue Cam Impingement in Adolescents: MRI Reveals Impingement Lesions Underappreciated on Radiographs,” and “Biomechanical Assessment of Bicortical Suspension Device Fixation for Proximal Tibiofibular Joint Instability: Single Versus Double Device.” Click here to read the articles.
(12.10.23) I denne episoden av Nova Noir tar Karin, Astrid og Karl Aksel + teknikker Maria deg gjennom filmfestivalen Mirage sitt program for 2023. I tillegg diskuterer de dokumentarene "Kunstneren og Tyven" og "Radiograph of a Family". Følg med!
In part 2 of this series, Dr. DeClue continues her deep dive into kissing spine, including some eye-opening data regarding its prevalence across the world. Some highlights in this episode include: The prevalence of back diseases in horses. 5:37 Impingement of the dorsal spine. 10:55 Kissing Spine Syndrome in thoroughbreds. 14:43 Kissing spine in horses in Malaysia. 21:45 Radiographic findings supporting a developmental vs. acquired etiology. 33:05 The 2023 paper from italy on kissing spine. 42:43 Are kissing spine lesions painful? 47:16 Stretching the dorsal spine. 52:43
AI Unraveled: Latest AI News & Trends, Master GPT, Gemini, Generative AI, LLMs, Prompting, GPT Store
How to Leverage No-Code + AI to start a business with $0Leverage ChatGPT as Your Personal Finance AdvisorWhat is Boosting in Machine Learning?Deep Learning Model Detects Diabetes Using Routine Chest RadiographsAI deep fake audios are getting scarily realisticMicrosoft's many AI monetization plansUnderstanding the Fuzzy Accuracy of Generative AIGoogle Search launched AI-powered grammar checker Zoom can now train its AI using customer dataThe end of ageing? A new AI is developing drugs to fight your biological clockAI model can help determine where a patient's cancer aroseSam Altman concerned about AI's impact on electionsJupyter brings AI to notebooksThis podcast is generated using the Wondercraft AI platform (https://www.wondercraft.ai/?via=etienne), a tool that makes it super easy to start your own podcast, by enabling you to use hyper-realistic AI voices as your host. Like mine! Get a 50% discount the first month with the code AIUNRAVELED50Attention AI Unraveled podcast listeners!Are you eager to expand your understanding of artificial intelligence? Look no further than the essential book "AI Unraveled: Demystifying Frequently Asked Questions on Artificial Intelligence," by Etienne Noumen, now available at Shopify, Apple, Google, or Amazon (https://amzn.to/44Y5u3y) today!
In this TIPisode we tackle the issue of time management as Andrew Johnston, RDH give his pointers for Prep, Tray Set-up, Radiographs, and Perio Charting. Like many things, it will take practice and repetition before these tips become habits but give it a real try! Andrew@ataleoftwohygienists.com
In this TIPisode we tackle the issue of time management as Andrew Johnston, RDH give his pointers for Prep, Tray Set-up, Radiographs, and Perio Charting. Like many things, it will take practice and repetition before these tips become habits but give it a real try! Andrew@ataleoftwohygienists.com
PRN: 4. How to interpret basic pathology on abdominal radiographs for an undergraduate clinical exam. Harry talks about bowel-related pathology including large and small bowel obstruction, volvulus, perforation and complications of inflammatory bowel disease. This is part of a subseries looking at key concepts for foundation year doctors that are not common conditions. This episode was written by Dr Harry Kingsley-Smith. Disclaimer: PRN episodes are not vetted by senior clinicians. If you think there are any errors in PRN episodes, would like to give feedback or episode suggestions - please email atoeasy@gmail.com Links: Recommended radiology website (in no way affiliated with the podcast): https://www.radiologymasterclass.co.uk/gallery/abdo/abdominal_xray/normal Further reading about Abdominal radiograph interpretation: https://geekymedics.com/abdominal-x-ray-interpretation/ Other resource used for fact checking (this resource is peer reviewed) Closed loop bowel obstruction: https://www.ncbi.nlm.nih.gov/books/NBK441888/
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Before x-rays were used for medical purposes, they were used for entertainment. X-rays are part of the electromagnetic spectrum and are utilized in a variety of radiography procedures that are currently taught to aspiring veterinary students. Liane Shaw, Diagnostic Imaging Senior Instructional Veterinary Nurse at the Purdue University College of Veterinary Medicine, describes the use of x-rays within these procedures and gives us a crash course in the history and properties of x-ray waves.
On this week's episode of Fast Facts – Coding Edition with Teresa Duncan, MS Teresa dives into radiographs and how if not taken, and documented properly, how they can get you into trouble. Links: DentistRX: https://www.dentistrx.com More Fast Facts: https://www.ataleoftwohygienists.com/fast-facts/ Teresa Duncan Website: https://www.katrinasanders.com Nobody Told Me That Podcast: https://nobodytoldmethat.libsyn.com/ Chew On This Podcast: https://chewonthisdentalpodcast.libsyn.com/
On this week's episode of Fast Facts – Coding Edition with Teresa Duncan, MS Teresa dives into radiographs and how if not taken, and documented properly, how they can get you into trouble. Links: DentistRX: https://www.dentistrx.com More Fast Facts: https://www.ataleoftwohygienists.com/fast-facts/ Teresa Duncan Website: https://www.katrinasanders.com Nobody Told Me That Podcast: https://nobodytoldmethat.libsyn.com/ Chew On This Podcast: https://chewonthisdentalpodcast.libsyn.com/
In this episode, Antonia and Andrew a selection of articles from the September 21, 2022 issue of JBJS, along with an added dose of entertainment and pop culture. Listen at the gym, on your commute, or whenever your case is on hold! Top of the Pile What’s New in Hip Replacement, by Morgan Host Perspectives of High-Income Country Orthopaedic Resident Rotations in Low and Middle-Income Countries, by Roberts et al. Deep Learning and Imaging for the Orthopaedic Surgeon. How Machines “Read” Radiographs, by Hill et al. What's Important: Dealing with Gun Violence, by Lachiewicz New Beginnings and Revealing Invisible Identities, by Bellamy et al. Diversity and Inclusion in Orthopaedic Surgery from Medical School to Practice, by Lamanna et al. Headlines Spontaneous Lumbar Curve Correction Following Vertebral Body Tethering of Main Thoracic Curves, by Catanzano et al. Applying Deep Learning to Establish a Total Hip Arthroplasty Radiography Registry. A Stepwise Approach, by Rouzrokh et al. Your Case is On Hold Serum Glucose Variability Increases the Risk of Complications Following Aseptic Revision Hip and Knee Arthroplasty, by Goh et al. Honorable Mention Defining Minimally Important Differences in Functional Outcomes in Musculoskeletal Oncology, by Gazendam et al.
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Host Dr. Ben Jackson interviews Roger A. Mann Award Finalist Mr. Martin Gregersen to discuss the research team's study of stability evaluation of Weber B ankle fractures observed with weight bearing radiographs leads to normal ankle congruence in patients treated nonoperatively. Thank you to CurveBeam for sponsoring this episode. For more information visit: https://curvebeam.com/ For additional educational resources visit https://aofas.org Looking for CME? AOFAS Podcast CME only on the ConveyMED Podcast App: Apple Store click here Google Play click here
Dental Radiography: Improving the Diagnostic Quality of Your RadiographsToday we are joined by Janet Simpson of DentalXrayCoach.com to discuss Dental Radiography, improving the diagnostic quality of your radiographs and much more!Obtaining quality radiographs would be easy if all our patients had big mouths, nice wide arches, high palettes, and straight teeth. However, we often have crowded arches, malposed and rotated teeth, touching gag reflexes, pushy tongues, chubby cheeks, and patients who tend to be exasperated or uncooperative. To make things even more difficult the wired sensors are smaller, harder, bulkier, more uncomfortable than film and black or dark blue. To top it off dental assistants that have been trained on the job "learned" to take dental X-rays in one weekend. They were never taught the secrets of shadow casting, or bisecting. My mission is to help. I've been a speaker, but would like to focus more of my attention to in person coaching.My co-worker Darlene is an RDAEF with over 40 years in dentistry. She and I want to spend more time in dental offices coaching dental assistants in all aspects of their job.Janet Simpson, is a registered dental assistant in San Diego California. She began her career in 1989 working in general and pediatric dental offices, but found her niche in education. Currently, she is a speaker, consultant and owner of Dental Fundamentals Continuing Education. she enjoys her roles as dental assistant, dental assisting instructor, clinic coordinator, and team trainer. She has presented "Rad Refresher" at the California Dental Association CDA presents multiple times, as well as smaller meetings and various study clubs. She is also an experienced trainer in regulatory compliance and California infection control requirements. Mrs. Simpson's vision for her training company, Dental Fundamentals C.E., is to study challenges, uncover solutions, and connect the learner to increased knowledge and skill. Because over 50% of all the dental assistants in the state of California have been trained on the job, providing access to quality education is one of her highest objectives. Her goal is to provide access to information that many training programs did not have time to present and to remove the barriers to professional growth. Janet has been recognized as an exemplary online instructor by San Diego Mesa College where she worked as an adjunct instructor for 5 years. Her online courses can be found at www.dentalxraycoach.comJanet is passionate about supporting the underserved. She enjoys her work as Clinic Coordinator of Cura Smiles Dental Clinic, where she facilitates volunteers providing pro bono oral healthcare to those in need in the heart of San Diego. Cura Smiles was recognized as Oral Health Champion for San Diego County in 2021. Want to learn more about Dental X-ray Coach?Visit: www.DentalXrayCoach.comWant to Listen to all of The Dental Brief Episodes?Visit: www.dentalbrief.comOur Sponsor: OmniPremier.com
Get CE off your to-do list! Start earning your CE credits today at https://rdh.tv/ce Eagle Syndrome: Dental Professionals can Identify Painful Condition on Panoramic Radiograph By Lara James, RDH Original article published on Today's RDH: https://www.todaysrdh.com/eagle-syndrome-dental-professionals-can-identify-painful-condition-of-panoramic-radiograph/ Get daily dental hygiene articles at https://www.todaysrdh.com Follow Today's RDH on Facebook: https://www.facebook.com/TodaysRDH/ Follow Kara RDH on Facebook: https://www.facebook.com/DentalHygieneKaraRDH/ Follow Kara RDH on Instagram: https://www.instagram.com/kara_rdh/
Con uno speciale dedicato al cinema in rapporto all'Ucraina dalla "Corazzata Potemkin" ai film di Velentin Vasjanovyc. Interviste a Marco Simon Puccioni su "Il filo invisibile"; a Firouzeh Khosrovani su "Radiograph of a family"; Donatella Diamanti sceneggiatrice della serie tv "Vostro Onore" e Martina Schmiedt direttrice artistica del festival di cortometraggi Max3Min. Tra le uscite: "Parigi tutto in una notte" di Catherine Corsini; "Il male non esiste" di Mohammad Rasolouf; "C'era una volta il crimine" di Massimiliano Bruni; "The Alpinist- Uno spirito libero" di Peter Mortimer e Nick Rosen; "Flee" di Jonas Poher Rasmussen.
Dental podcast: Welcome to DentalTalk. I'm Dr. Phil Klein. Today we'll be discussing a sensible and proven strategy to implement digital radiology in the practice of pediatric and family dentistry. We'll talk about the advantages and disadvantages of available technologies. Our guest is Dr. Juan F. Yepes, a full professor in the Department of Pediatric Dentistry at Indiana University and an attending at Riley Children Hospital in Indianapolis, Indiana.
The image provided by the X-ray is a constant I rely on.
Firouzeh Khosrovani's “Radiograph of a Family” is among the rarest of documentaries. Like a perfectly composed classical symphony, the film's form and content effortlessly complement each other. The result is a film that is both beautifully symmetrical and dynamically creative. Seamlessly moving between the personal and the political, Firouzeh employs the full range of storytelling tools--from re-enactments and staged dialogue, to family photographs and archival footage--to portray how the 1979 Iranian Revolution upended her parents' marriage and caused a surprising role reversal in the fortunes of her mother and father. Mike had the opportunity to talk in-depth with Firouzeh about her stunning film, winner of the top prize at the 2020 International Documentary Film Festival Amsterdam (IDFA). How did the Iranian Revolution disrupt the family dynamic and almost literally cut the family's Tehran home in half? What was it like for Firouzeh to be caught between “two lifestyles, two ideologies and two realities”? Did her mother really marry a photograph? And, Firouzeh answers the biggest question of all: how can love endure when everything else seems to be coming apart?
Full article: https://www.ajronline.org/doi/abs/10.2214/AJR.21.26882 Early and mild stages of intersitial lung disease can be challenging to evaluate by radiography. A commercially available deep learning algorithm to detect reticular opacities in surgically confirmed interstitial lung disease was more accurate than radiologists. Gregory Lee, MD discusses a new AJR article that examines the use of a deep learning algorithm tool increased interobserver agreement for readers, as well as increased the sensitivity, specificity and accuracy of the radiologist.
Featuring: Ram Haddas, PhD, MBA, Yigal Samocha, MD, Bassel Diebo, MD Aging, vestibular deficits, neurologic conditions, neuromuscular disease, peripheral neuropathies, and abnormal spinal curvatures, all predispose an individual to postural instability and may alter their balance. Currently, most spinal surgeons rely on static radiographic parameters for objective alignment and balance data alongside patient-reported outcome measures. Radiographs have often been used as an indirect measure of balance; however, as our understanding of balance has evolved the importance of postural stability has become more appreciated. Postural stability encompasses a variety of factors including alignment, sensory inputs, muscle conditioning, and response to external stimuli. Although the ability to radiographically measure balance has significantly improved, the clinical measurements, implications, and prognosis of balance and sway have remained difficult to quantify. Disclosures: Haddas, Ram: Consulting: Medtronic (E); Grants: Alphatec (E, Outside 12-Month Requirement, Paid directly to institution/employer), Aspen Medical Products (F, Paid directly to institution/employer), Medtronic (F, Paid directly to institution/employer), SI-BONE (F, Paid directly to institution/employer), The Cervical Spine Research Society (C, Outside 12-Month Requirement, Paid directly to institution/employer). Samocha, Yigal : Nothing to Disclose Diebo, Bassel G.: Nothing to Disclose Key: A: $100-$1,000; B: $1001-$10,000; C: $10,001-$25,000; D: $25,001-$50,000; E: $50,001-$100,000; F: $100,001- $500,000; G: $500,001-$1M; H: $1,000,001- $2.5M; I: $2.5M+
No Time To Die, but plenty of time for us to discuss this film. Non-spoiler for the first 30 minutes, then capsule reviews of two documentaries that streamed as part of SFF's on demand contingent - then another half hour of spoiler discussion.
In our virtual studio joining myself and Brian we are delighted to have Dr Rhiannon Morgan, one of our fabulous lecturers in Equine Diagnostic Imaging here at the RVC. We talk to Rhiannon about pre-purchase radiographs and expand to all forms of diagnostic imaging. Some common things to look out for and when you should ask for another opinion. Rhiannon is very familiar to podcasting as she is the host of the EVJ In conversation podcast, though it is the first time for her to be the guest, and we are delighted that she joined us. We hope that you enjoy. Information on Pre-purchase examinations https://www.beva.org.uk/Guidance-and-Resources/PPEhttps://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/equine-pre-purchase-examinations/ Some papers of interest https://pubmed.ncbi.nlm.nih.gov/34687227/https://pubmed.ncbi.nlm.nih.gov/33862666/https://pubmed.ncbi.nlm.nih.gov/31418917/ To Cite this podcast as: Dom Barfield. RVC Clinical Podcast 130 Pre-purchase radiographs with Rhiannon Morgan. Published on Nov 18 2021 If you have any comments about this podcast, please get in touch: email dbarfield@rvc.ac.uk; tweet @dombarfield. We would greatly appreciate your time to rate us on Apple podcast or Acast and kindly write us a review.
In today's VETgirl podcast, we interview Dr. Neil Shaw, DACVIM on the use of artificial intelligence (AI) in veterinary medicine. What is the role of technology and AI in radiology, and can this help veterinary professionals with time management, diagnostic quality, and overall improvements in veterinary medicine globally? Tune in as we learn about the use of AI in veterinary medicine, specifically in the area of diagnostic imaging and radiographic interpretation. Today's VETgirl's podcast is sponsored by SignalPET. SignalPET's advanced technology utilizes machine learning and artificial intelligence to assess radiographs in real-time for normals and abnormals on 50+ radiographic tests. You take x-rays. Your images instantly get reviewed by SignalPET's AI. And you get your test results in addition to a custom client-facing radiology report, in just 10 minutes or less. Help your veterinary team provide faster intervention, less expensive care, and enhanced patient outcomes during radiographic procedures. Visit www.signalpet.com/vetgirl for more information.
Cristina Bianciardi e Claudio Zito parlano del film di Firouzeh Khosrovani
Dr. Graham interviews Dr. Jonas Matzon regarding his article “Reliability of Radiographs and Computed Tomography in Diagnosing Scaphoid Union After Internal Fixation”, which appears in the July 2021 issue of the Journal of Hand Surgery.
In Weber B/SER2-4 ankle fractures, assessment with weightbearing radiographs to ascertain stability of the ankle mortise has been advised. However, no previous studies report whether this method leads to preservation of normal ankle congruence. The purpose is to evaluate equivalence of ankle congruence of injured ankles after fracture union, vs the uninjured side, for stable SER2 and partially unstable SER4a fracture types. In conclusion, assessment of stability of Weber B SER2/4a ankle fractures, with weightbearing radiographs, also predicts preservation of normal ankle congruence in those deemed stable, with no difference between SER2 and SER4a fracture types. Further, excellent reproducibility of the method of obtaining medial clear space measurements was demonstrated. To view the article click here.
The Noobie Dentist Podcast – Nu Dastaran Episode Run Time: 00:45:21 Intro Today, I talk to Dr. Nu Dastaran, an oral and maxillofacial surgeon in Melbourne. Originally from London, she graduated with a medical degree from the University of Bristol. Through exposure to and her interest in head and neck anatomy Dr. Dastaran decided to start the journey towards becoming an OMFS. She completed her OMFS training in Australia and has been practicing as an OMFS for 5 years now. In this second episode of the dental implant audio residency series, we talk about the surgical aspects of implant dentistry. Dr. Nu Dastaran details her workflow from patient assessment, surgery planning, flap design, down to the actual implant procedure. We also discuss her preference for single vs two stage implant procedures and freehand vs guided placements. Guest Details Social Media: Nu Dastaran LinkedIn Instagram: https://www.instagram.com/oralandfacialsurgeon/ Radiograph on Noobie Dentist Website: https://noobiedentist.com/wp-content/uploads/2021/04/Untitled-1.png Time Stamps [04:30] How Dr. Nu specialised in oral and maxillofacial surgery [07:48] Dr. Nu’s day to day practice as an OMFS [10:41] Patient assessment & diagnosis in implant treatment [16:52] Analysis of a sample radiograph [23:10] Implant surgery procedure from start to finish [27:18] One-stage VS two-stage implant placements [29:01] Uncovering a dental implant [30:09] Freehand placement vs guided placement [31:38] Tips for preparing implant site [38:47] Focus on the long-term prognosis [40:58] Using guided placement as a learning tool [43:21] Don’t be hard on yourself Podcast Details As always, if you enjoyed listening to the Noobie Dentist Podcast, please pass the podcast along to your friends, classmates and colleagues. If you haven’t already, head over to iTunes and give the show a 5-star rating and if you have some time, leave a review! The Noobie Dentist podcast is now available on Spotify, YouTube, noobiedentist.com, the Apple podcast app, Stitcher and any other podcast apps out there! Website: http://www.noobiedentist.com Instagram: @noobiedentist Sponsor Details MoreDent is driving the charge forward in integrated digital dentistry by providing world class education, equipment, products, solutions, and support to thousands of practices. Their goal is simple: to enhance clinical and patient outcomes so that dentists and patients alike can enjoy the highest possible level of success. To find out more, visit www.moredent.com.au Conclusion Do you plan to specialise in implant dentistry? Did you find Dr. Nu’s tips useful? We would love to hear your thoughts! Remember to subscribe for more content!
Ivča zve do Salisbury a na Dokumentární jaro / Ozvěny 24. Ji.hlavy, Franta se poprvé podíval na Příběh Alvina Straighta a Honzovi se nic nelíbilo. Další Odvážné palce jsou tady:Cherry (Honza
The same concentration to detail and care is paramount in this special demographic to pinpoint these minute changes in biomechanics. X-rays help with this matter.
Full article: https://www.ajronline.org/doi/abs/10.2214/AJR.20.24801 In this podcast, Pei-Kang (Ken) Wei, MD and Diana Litmanovich, MD first summarized the study by Reeves et al. and then provided an in-depth discussion about the current status and future direction of utilizing chest radiograph as a guiding tool for clinical management. Key aspects of the discussion are the practicality and applicability of the scoring system developed by Reeves et al., chest radiograph as a more desirable modality for evaluating patients with COVID-19 compared to CT, and chest radiograph as an outcome predictor.
Yogi Sharp talks about various studies that have affected the way he approaches his shoeing and hoofcare, as well as what owners can notice to see if their horse is moving in a good direction in regards to hoof health. Yogi also discusses what we should strive for in a healthy hoof. For more information, see The Equine Documentalist: https://www.theequinedocumentalist.com/
Where is the vertebral subluxation? X-ray analysis helps us answer that question.
In this episode, veterinarian Dr. Rachael Shuster teaches how to read radiographs with foot pathology. You'll get a lot out of this episode discussing this important topic of benefit to farriers and veterinarians from a previous Farrier Focus conference.
Another episode with Dr. Susan and Dr. Jolle where they discuss the use of diagnostic imaging techniques in veterinary practice. What is the difference between an X-ray, an ultrasound, and a CT scan? Why can these techniques help your veterinarian in understanding what is wrong with your pet? Join us for another exciting episode.
In this episode, Monique Craig of EponaMind in Paso Robles, California talks about how Epona's MetronMind software has allowed them to watch for various trends in hoof radiographs. She discusses what they have come to look for when watching for mediolateral balance as well as HPA, and what we might consider as we approach the hoof and think about our trimming or therapeutic options such as the EponaShoe. Also featured in the episode: John Machamer, Ann Ramsey, and Lenora Pritchard.
Show Notes Differentiating bronchiolitis from asthma and reactive airway disease in young children can be challenging, and a rapidly changing clinical presentation can confound accurate assessment of the severity of the illness. This episode reviews risk factors for apnea and severe bronchiolitis; discusses treatments/therapies and provides evidence-based recommendations for the management of pediatric patients with bronchiolitis. Show More v Pathophysiology Bronchiolar narrowing and obstruction is caused by: Increased mucus secretion Cell death and sloughing Peri-bronchiolar lymphocytic infiltrate Submucosal edema Smooth muscle constriction seems to have a limited role, perhaps explaining the lack of response to bronchodilators. Median duration of illness is 12 days in children 2 yo.3 Late fall epidemic peaking Nov-March, in the US.4 Human Metapneumovirus (HMPV) accounts for 3-19% 5,6 Similar seasonal variation to RSV. Parainfluenza, influenza, adenoviruses, coronaviruses, rhinoviruses, and enteroviruses are other causes.4-6 Rhinoviruses have been shown to play a larger role in Asthma.7 Presentation The American Academy of Pediatrics defines it as any of the following in infants: 1 Rhinitis Tachypnea Wheezing Cough Crackles Use of accessory muscles Nasal flaring Differential Diagnosis Emergent Causes Infection: pneumonia, chlamydia, pertussis Foreign body: aspirated or esophageal Cardiac anomaly: congestive heart failure, vascular ring Allergic reaction Bronchopulmonary dysplasia exacerbation Non-acute Causes Congenital anomaly: tracheoesophageal fistula, bronchogenic cyst, laryngotracheomalacia Gastroesophageal reflux disease Mediastinal mass Cystic fibrosis Clinical Pearls Vomiting, wheezing, and coughing associated with feeding; consider GERD. Wheezing associated with position changes; consider tracheomalacia or great vessel anomalies. Wheezing exacerbated by flexion of neck and relieved by neck hyperextension; consider vascular ring. Multiple respiratory tract infections and failure to thrive; consider cystic fibrosis or immunodeficiency. Wheezing with heart murmur, cardiomegaly, cyanosis, exertion or sweating with feeding; consider cardiac disease. Sudden onset of wheezing and choking; consider foreign body. Risk Factors for Severe Bronchiolitis Age < 6-12 weeks11-13 Prematurity < 35-37 weeks’ gestation11-13 Underlying respiratory illness such as bronchopulmonary dysplasia1 Significant congenital heart disease; immune deficiency including HIV, organ or bone marrow transplants, or congenital immune deficiencies14,15 Altered mental status (impending respiratory failure) Dehydration due to inability to tolerate oral fluids Ill appearance12 Oxygen saturation level ≤ 90%1 Respiratory rate: > 70 breaths/min or higher than normal rate for patient age1,12 Increased work of breathing: moderate to severe retractions and/or accessory muscle use1 Nasal flaring Grunting Risk Factors for Apnea Full-term birth and < 1 month of age16,17 Preterm birth (< 37 weeks’ gestation) and age < 2 months post birth11-13,17 History of apnea of prematurity Emergency department presentation with apnea17 Apnea witnessed by a caregiver17 Diagnostic Testing Xray Radiographs increase the likely hood of a physician giving antibiotics, even if the X-ray is negative.18-20 Routine radiography is discouraged, but may be helpful when severe disease requires further evaluation or exclusion of foreign body. Viral testing is not necessary for the diagnosis but may help when searching for the cause of fever in young infants. 2016 ACEP fever guidelines note that positive viral testing can impact further workup of fever for a serious bacterial infection (SBI).21 In infants 90% Clinicians may choose not to use continuous pulse oximetry (weak recommendation due to low-level evidence and reasoning)1 Fluids IV or NG administration of fluids to combat dehydration, until respiratory distress and tachypnea resolve. Suctioning Routine use of “deep” suctioning may not be beneficial and may be harmful.1 Nasal suction should be used to help infants with respiratory distress, poor feeding or sleeping. Bronchodilators1,25,26 Generally nor recommended for routine use. May trial in infants with: Severe bronchiolitis (these were excluded in the studies). History of prior wheezing. Family history of atopy/asthma in an older infant. Anticholinergic Agents (ipratropium bromide) No evidence for improvement in bronchiolitis.31-34 Corticosteroids AAP1, Cochrane Review27, and PECARN28 study all recommend against, finding no evidence for improvement. One small study (70 patients) found a benefit utilising 1 mg/kg oral dexamethasone followed by 0.6 mg/kg daily for 5 days. However, the study limited by size and increased prevalence of family history of atopy. Recommendations remain against use in first time wheezers with bronchiolitis. Racemic Epinephrine Not recommended1. Further study needed. Racemic Epinephrine + Oral Dexamethasone Pediatric Emergency Research Canada trial at 8 Canadian pediatric EDs involving 800 infants aged 6 weeks to 12 months with bronchiolitis found that the epinephrine-dexamethasone group had a lower admission rate over 7 days than the placebo group (17.1% vs 26.4%). This was not statistically significant. Further study needed. 30 Hypertonic Saline AAP guidelines do not recommend use in the ED but note clinicians may utilize it in the inpatient setting. 1 Cochrane reviews in 2013 and 2017 found some inpatient benefit, but a conflicting publication found it may worsen cough.35-37 High Flow Nasal Cannula (HFNC) Several small pediatric ICU studies show a benefit in severe cases. No large ED randomized trials exist, to date. Study protocols included weight based or age based flow rates. Nasal CPAP Shows benefit in pediatric ICU settings. Evidence vs HFNC is limited. Disposition Consider admission if any of the following are present: Risk for apnea Risk for severe bronchiolitis Respiratory distress, particularly if it interferes with feeding Hypoxia (oxygen saturation ≤ 90%) Decreased feeding and/or dehydration An unreliable caregiver (ie, unable to ensure patient care and appropriate 24-hour follow-up) All patients with severe bronchiolitis should be admitted.
What Hygienists Should Say When Patients Refuse Dental Radiographs By Katharyn Edwards, RDH Original article published on Today's RDH: https://www.todaysrdh.com/what-hygienists-should-say-when-patients-refuse-dental-radiographs/ Podcast audio article sponsored by Philips Sonicare. Follow their Instagram just for dental professionals here: https://www.instagram.com/philipssonicarepro/ Get daily dental hygiene articles at https://www.todaysrdh.com Follow Today's RDH on Facebook: https://www.facebook.com/TodaysRDH/ Follow Kara RDH on Facebook: https://www.facebook.com/DentalHygieneKaraRDH/ Follow Kara RDH on Instagram: https://www.instagram.com/kara_rdh/
Brought to you by CSMi Is more better? Would additional tests improve outcomes? How often do we look for things that may not actually make a difference? We explore these questions as we review this non-inferiority study on managing wrist fractures. Omitting Routine Radiography of Traumatic Distal Radial Fractures After Initial 2-Week Follow-up Does Not Affect Outcomes. van Gerven P, El Moumni M, Zuidema WP, Rubinstein SM, Krijnen P, van Tulder MW, Schipper IB, Termaat MF. J Bone Joint Surg Am. 2019 Aug 7;101(15):1342-1350. doi: 10.2106/JBJS.18.01160. Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. That said, if you are having difficulty obtaining an article, contact us. Produced by: Matt Hunter Music for PT Inquest: "The Science of Selling Yourself Short" by Less Than Jake Used by Permission
Tips for When Patients Question or Refuse Radiographs By Debbi Viger, RDH, BHS Original article published on Today's RDH: https://www.todaysrdh.com/tips-patients-question-refuse-radiographs/ Podcast audio article sponsored by Philips Sonicare. Follow their Instagram just for dental professionals here: https://www.instagram.com/philipssonicarepro/ Get daily dental hygiene articles at https://www.todaysrdh.com Follow Today's RDH on Facebook: https://www.facebook.com/TodaysRDH/ Follow Kara RDH on Facebook: https://www.facebook.com/DentalHygieneKaraRDH/ Follow Kara RDH on Instagram: https://www.instagram.com/kara_rdh/
Editor in Chief Fred Rivara and Deputy Editor Steve Fihn discuss research published in JAMA Network Open in July 2019. Read the Highlights article here
Summary: Dr. Cerniglia presents a simple “ABCDEs” pneumonic (adapted from ABCs of Dr. Forrester’s original monograph Radiology of Joint Disease) to structure an approach to hand and wrist radiographs in patients with suspected or known arthritis: A = Alignment B = Bone production & density C = Cartilage space D = Distribution E = Erosions S = Soft tissues The possible findings of each of these radiographic features are introduced. Specific arthritis features will be discussed in more details in upcoming episodes. Host: Hao Lo, MD. Assistant Professor of Radiology, Division of Emergency Radiology, UMMS Dept of Radiology. Guest: Christopher Cerniglia, DO, ME, FAOCR. Associate Professor of Radiology, Division of Musculoskeletal Imaging & Intervention, UMMS Dept of Radiology. Resources: • Brewer, AC, Flemming, DJ, Bernard, SA (2012). Chapter 2: Evaluation of the Hand Film. Arthritis in Black and White, 3rd edition. Philadelphia, PA. Elsevier.
Author: Ryan Circh, MD Educational Pearls: Ulnar collateral ligament injury is often called gamekeeper’s thumb or skier’s thumb Can results from traumatic deviating the thumb radially (abduction) Poor rabbits Have a low threshold for referral to hand surgery for follow up - treatment for minor injuries can be conservative but more severe require surgery to preserve function This injury should be placed in a thumb spica splint Radiographs are often negative unless an avulsion fracture is present Editor’s note: to test for UCL injuries, I like this. References: Schroeder NS, Goldfarb CA. Thumb ulnar collateral and radial collateral ligament injuries. Clin Sports Med. 2015 Jan;34(1):117-26. doi: 10.1016/j.csm.2014.09.004. Epub 2014 Oct 11. Review. PubMed PMID: 25455399. Madan SS, Pai DR, Kaur A, Dixit R. Injury to ulnar collateral ligament of thumb. Orthop Surg. 2014 Feb;6(1):1-7. doi: 10.1111/os.12084. Review. PubMed PMID: 24590986. Summarized by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD
Dr Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Can proteomic biomarkers distinguish between subtypes of aortic stenosis even years before surgery? Well, to find out more, stay tuned. That's coming right up after these summaries. The first original paper this week adds to the evidence that smoke-free policies are associated with a lower risk of cardiovascular disease. First and corresponding author, Dr Mayne from Northwestern University Feinberg School of Medicine, and her colleagues linked smoke-free policies to participants of the Coronary Artery Risk Development in Young Adults, or CARDIA study, which has a follow-up of up to 20 years. They found that smoke-free policies in workplaces were associated with significantly lower risk of incident cardiovascular disease after controlling for a wide range of covariants. Results were weaker for bar and restaurant bans, but in the same direction. Preventive fractions range from an impressive 24 to 46%. Thus, smoke-free policies may improve cardiovascular health through reducing population exposure to tobacco smoke. However, we should remember that much of the US population remains unprotected by smoke-free policies. Thus, taken together with prior ecological work, these results support the continued expansion of smoke-free policies in indoor public places. Most phase-3 randomized control trials feature time-to-first event end points for their primary analysis. In chronic diseases, however, a clinical event can occur more than once and recurrent event methods have been proposed to more fully capture the disease burden, as well as to improve statistical precision and power. However, is this really the case? This question was examined by first author, Dr Brian Claggett, corresponding author, Dr Scott Solomon, from Brigham Women's Hospital in Boston, Massachusetts, and their colleagues, who sought to better characterize factors that influence the statistical properties of recurrent events and time-to-first event methods in the evaluation of randomized therapy. They performed repeated simulated trials with 1:1 randomization of 4000 patients to active versus control therapy. Through simulation, they varied the degree of between-patient heterogeneity of risk as well as the extent of treatment discontinuation. They then compared their findings with those from the actual randomized control trials. The authors found that the statistical power of both recurrent events and time-t- first event methods were reduced by increasing heterogeneity of patient risk, a parameter that's not usually included in conventional power and sample size formulae. Furthermore, data from real clinical trials were consistent with the simulation studies, confirming that the greatest statistical gains from the use of recurrent events methods occurred in the presence of high patient heterogeneity and low rates of study drug discontinuation. The next paper uncovers a novel biomarker and therapeutic target of pulmonary arterial hypertension, and that is selenoprotein P. First author Dr Kikuchi, corresponding author, Dr Shimokawa, from Takaoka University Graduate School of Medicine in Japan and their colleagues performed micro-array analyses using pulmonary arterial hypertension, pulmonary artery smooth muscle cells, and found a 32-fold up regulation of selenoprotein P compared with controls. Selenoprotein P promotes cell proliferation and apoptosis through increased oxidative stress and mitochondrial dysfunction. Using five strains of genetically modified mice, the authors demonstrated a pathogenic role of selenoprotein P in the development of hypoxia-induced pulmonary hypertension. Furthermore, sanguinarine, which is an orally active small molecule identified by throughput screening reduced selenoprotein P expression and pulmonary arterial smooth muscle cell proliferation and ameliorated pulmonary hypertension. In summary, this study shows that selenoprotein P plays a crucial role in the pathogenesis of pulmonary arterial hypertension and may be a useful and novel biomarker and therapeutic target in this disorder. Familial hypercholesterolemia is known to be associated with a high risk of ischemic heart disease, including myocardial infraction, but what about the risk of ischemic stroke? Well, first author, Dr Beheshti, corresponding author, Dr Nordestgaard, from Copenhagen University Hospital and their colleagues examined the associations of familial hypercholesterolemia and high LDL cholesterol with ischemic stroke in both causal, genetic, and observational analyses using more than 106000 individuals from the Copenhagen General Population Study, and more than 10000 individuals from the Copenhagen City Heart Study. They used a Mendelian randomization design to test whether high LDL per se had a causal effect on ischemic stroke risk using a combination of the familial hypercholesterolemia causative mutations and common genetic variants associated with high LDL. The authors found that there was no association between familial hypercholesterolemia mutations and ischemic stroke risk. In the Mendelian randomization analysis, also including common genetic variants, there was also no causal effect of high LDL on the risk of ischemic stroke. These findings imply that the predominant goal of targeting LDL lowering in those with and without familiar hypercholesterolemia is likely to reduce myocardial infractions, rather than ischemic stroke. Well, that wraps it up for our summaries. Now for our feature discussion. Circulation publishes numerous papers regarding circulating biomarkers. We talk about biomarkers in the diagnostic, prognostic sense, but what about in a pathophysiologic sense, and especially in a disease as important as aortic stenosis? Well, that's what our featured paper this week is all about and I'm so excited to have with us corresponding author, Dr Stefan Söderberg, from Umeå University in Sweden, as well as our associate editor, Dr Peipei Ping from UCLA. We will be discussing the paper entitled “Proteomic Biomarkers for Incident Aortic Stenosis Requiring Valvular Replacement.” Stefan, could you tell us a bit about what made you look at this very interesting question, and perhaps the unique resources you had in Sweden to look at this? Dr Stefan Söderberg: I'm a practicing cardiologist, and I have been working a lot with aortic stenosis over the years. It's frustrating that we can't do anything to stop the process. In many cases, the patients are old and frail, and if you could find the means to stop the process long before they need surgery, it will be of great benefit for the human and for the society. Also, knowing that the interventions on the statins, for example, have been unsuccessful, we thought that there must be better ways or other biomarkers. Furthermore, that many of these studies, the phenotype of aortic stenosis has been very poorly described and there is probably much more behind just aortic stenosis than just, for example, calcium deposits in an X-ray, et cetera, et cetera. Dr Carolyn Lam: You used some very unique resources in Sweden to therefore look at the proteomic signatures of aortic stenosis. Could you describe that and simplify perhaps the results so we can understand it? Dr Stefan Söderberg: First of all, I got this idea from other studies done up in northern Sweden. If you have an absolutely unique setting, the combination of huge population-based studies in 30 years back, we have a huge biobank with examples of extraordinary good quality from each of these participants. For example, for each participant, the blood has been spun and put into freezer, deep freezer, within one hour for 30 years, and they are now, as I said, about 100000. Furthermore, I'm working as a cardiologist at a university, and up here, you do all of the aortic surgery for the whole northern Sweden. That is, we can combine the names of the person undergoing surgery together with these population-based surveys and we can get details from all those who have participated in the surveys long before they did the surgery, and they can go and retrieve samples from cases and match controls from the freezers. It's a unique setup. Then, when we were designing the study, we got the chance to get these analyses done by our friends at the university to get the proteomic analysis via a unique data technique. Dr Carolyn Lam: Wow. Could you describe your results? Dr Stefan Söderberg: The results that we found in the first set of 334 patients who underwent surgery is 10 years after their first sampling, we found six proteins. Then, we got the question back from Circulation to establish a validation cohort, and we were able to do so to include all those new cases in the last 2 years, and there we could replicate five of these proteins. The interesting thing that the pattern is completely different between those having coronary artery disease from those without. That kind of phenotyping has not been done throughout other aortic stenosis studies. Therefore, this study is unique. We have had two papers in the last year in the Journal of American Heart Association from the cohort, as well, showing the thing that happened. For example, lipoprotein little A is only associated with future aortic stenosis valve replacement only in those with concomitant coronary artery disease. There are many unique things, the prospective design, and the phenotype differentiating those with and without coronary artery disease. Dr Carolyn Lam: Yeah, and if I may just reiterate that the population base that you work with is just enviable and just so that the audience realizes, these are biomarkers that were collected 11 years before the aortic stenosis surgery, isn't it? You really had a long follow-up. Also, just to let everyone know, it was a proximity extension assay that you used for the discovery, and the six proteins were growth differentiating factor 15, or GDF15, galectin-4, von Willebrand factor, interleukin 17 receptor A, transferrin receptor protein 1, and PCSK9, so very interesting. Peipei, you have a way of putting things into context so beautifully. Could you tell us your thoughts when you saw this paper? Dr Peipei Ping: I thought this is a very high-quality study that actually benefited from the long-term established, well-controlled cohort in northern Sweden, as Dr Söderberg just shared with us. On the other end, it married a technology platform that's very well-established and -validated, and this situation targeted proteomics platforms using multi-proximity extension assays with carefully controlled markers and screened 92 cardiovascular candidate markers. This is the kind of approach that provides semi-quantitative as well as quantitative outputs and is capable to offer validated screens on large population clinical subsets. A study of such with a high value cohort combined with a validated and well-controlled technology platform offered results that clearly have clinical significance, as well as setting up examples for other studies to follow. The enthusiasm from the editorial boards, as well as the reviewers, have been substantially high and supportive. Dr Stefan Söderberg: Fantastic. I'm very glad to hear this. Dr Carolyn Lam: Stefan, you also mentioned that a very unique element was the separation of aortic stenosis with and within coronary artery disease, or at least established or visible coronary artery disease. Could you explain how that provided pathophysiologic insights? Dr Stefan Söderberg: First, I should say we were very, very strict. Our routine is that everyone was 100% undergoing, aortic valve replacement, they undergo a coronary angiogram before. If we saw any sign of atheromatosis, it was not enough that they had the significant stenosis, but any signs, they were put into the group of coronary artery disease. Those without, we couldn't see anything there. Radiograph here reported absolutely clean coronary arteries. Of course, we cannot exclude if there were aortic changes within them all, of course. We believe that this is a very important message that in order to further study aortic stenosis, we should be very careful in phenotyping the disease. We hope the growing cohort will be able to do this further. For example, cuspid versus tricuspid valves, women versus men, et cetera. My answer in short is phenotype. Let me take one example which I found very, very exciting. That is the finding of PCSK9, which is closely related not only to cholesterol symptoms, but also to lipoprotein little A emphasis. As you know, the first strong finding in aortic stenosis was the LP little A. This is related to that genetic finding, and that was in the huge study from Canada. They did not have the same phenotyping, so we had information to his important findings. That's one example. Another example is the transferring receptor, where data has shown that bleeding acutely in the valvular tissue causes damage, and this relates iron metabolism to the formation of the aortic valve. Obviously, it seems that the process in the aortic valve is very much similar to the vessel arteriosclerosis. It seems to be different. This is the indication that when we formulate new studies or new drugs on aortic stenosis, we must be very careful to use the right drug for the right type of valvular disease. Dr Carolyn Lam: Those are great points. Peipei, do you think that's the main clinical take-home message, beyond that great comment you made earlier that this paper's just a great example of the use of tools, modern tools, that we have in proteomic characterization like the proximity extension assay to provide pathophysiologic insights when you have a really well-phenotyped cohort? What's the critical take-home message, though? Is there one now? Dr Peipei Ping: The take-home message is marriage of amazing high value cohort's data sets with that of the well-controlled clinical study using target proteomics approaches. In this particular study, one main critical innovation is the study is capable of providing insights regarding molecular signatures that have predicted values. As stated in the manuscript, the circulating proteins that found critically important, their alterations took place years before the surgery were associated with aortic stenosis. That is of value, clinical value, to many other clinical studies to follow. Dr Carolyn Lam: Wow. That's wonderful. Thank you so much for putting these findings in context for us. Thank you, listeners, for joining us today. Don't forget to tune in again next week.
In today's VETgirl online veterinary continuing education podcast, we discuss whether you detect pericardial effusion and cardiac tamponade on chest radiographs in veterinary medicine.
In today's VETgirl online veterinary continuing education podcast, we discuss whether you detect pericardial effusion and cardiac tamponade on chest radiographs in veterinary medicine.
Phil Eckman and Kevin Criscitiello are two past dental school roommates from the University of Maryland. They both have been in private practice for 8 years and have decided it is time to give back to more patients. In 2017 they invented XrayUpload.com to help people across the globe.
You are listening to Bark & Wag 15 Minute Vet Talk and I am your host Polly ReQua. Today we are talking with Dr. Susan McMillan, owner of Vet to Pet Mobile Veterinary Service in Burlington, Vermont to shed light on distemper. Canine Distemper in Dogs Canine distemper is a contagious and serious viral illness with no known cure. The disease affects dogs, and certain species of wildlife, such as raccoons, wolves, foxes, and skunks. The common house pet, the ferret, is also a carrier of this virus. Canine distemper belongs to the Morbillivirus class of viruses, and is a relative of the measles virus, which affects humans, the Rinderpest virus that affects cattle, and the Phocine virus that causes seal distemper. All are members of the Paramyxoviridae family. Young, unvaccinated puppies and non-immunized older dogs tend to be more susceptible to the disease. Symptoms and Types of Distemper in Dogs The virus, which is spread through the air and by direct or indirect (i.e. utensils, bedding) contact with an infected animal, initially attacks a dog’s tonsils and lymph nodes and replicates itself there for about one week. It then attacks the respiratory, urogenital, gastrointestinal, and nervous systems. In the initial stages of Canine Distemper, the major symptoms include high fever (≥103.5 ° F, or 39.7° C), reddened eyes, and a watery discharge from the nose and eyes. An infected dog will become lethargic and tired, and will usually become anorexic. Persistent coughing, vomiting, and diarrhea may also occur. In the later stages of the disease, the virus starts attacking the other systems of the dog’s body, particularly the nervous system. The brain and spinal cord are affected and the dog may start having fits, seizures, paralysis, and attacks of hysteria. Canine distemper is sometimes also called “hard pad disease” because certain strains of the virus can cause an abnormal enlargement or thickening of the pads of an animal’s feet. In dogs or animals with weak immune systems, death may result two to five weeks after the initial infection. Causes of Distemper in Dogs The disease can be acquired from improperly attenuated vaccines, though this occurs rather rarely. Bacterial infections of the respiratory or gastrointestinal systems may also increase an animal’s vulnerability to the disease. Non-immunized dogs that come into any kind of contact with an infected animal carry a particularly high risk of contracting the disease. Diagnosis of Canine Distemper in Dogs Canine distemper is diagnosed with biochemical tests and urine analysis, which may also reveal a reduced number of lymphocytes, the white blood cells that function in the immune system in the initial stages of the disease (lymphopenia). A serology test may identify positive antibodies, but this test cannot distinguish between vaccination antibodies and an exposure to a virulent virus. Viral antigens may be detected in urine sediment or vaginal imprints. Haired skin, nasal mucous, and the footpad epithelium may be tested for antibodies as well. Radiographs can only be used to determine whether an infected animal has contracted pneumonia. Computed tomography (CT) and magnetic resonance imaging (MRI) scans can be used to examine the brain for any lesions that may have developed. Treatment for Distemper in Dogs Unfortunately, there is no cure for canine distemper. Treatment for the disease, therefore, is heavily focused on alleviating the symptoms. If the animal has become anorexic or has diarrhea, intravenous supportive fluids may be given. Discharge from the eyes and nose must be cleaned away regularly. Antibiotics may be prescribed to control the symptoms caused by a secondary bacterial infection, and phenobarbitals and potassium bromide may be needed to control convulsions and seizures. There are no antiviral drugs that are effective in treating the disease. Living and Management for Canine Distemper In the more acute stages of canine distemper, it is necessary to monitor for development of pneumonia or dehydration from diarrhea. The central nervous system (CNS) must also be monitored because seizures and other neural disturbances may occur. A dog's chances for surviving canine distemper will depend on the strain of the virus and the strength of the dog’s immune system. Recovery is entirely possible, although seizures and other fatal disturbances to the CNS may occur two to three months after recovery. Fully recovered dogs do not spread or carry the virus. Prevention of Distemper in Dogs The best prevention for canine distemper is routine vaccinations and immediate isolation of infected animals. Special care must be taken to protect new-born pups from exposure, since they are especially susceptible to the disease. This episode is sponsored by BarkBox. Please use vettalk to receive one month free when you join for six months.
Taylor, G Evaluation Of The Chest Radiograph Podcast 010416 by OPENPediatrics
"She won't walk", or "He just looks like he's limping". So many things can be going on -- how do we tackle this chief complaint? You’re dreading a big work-up. You almost want to tell the kid – please, STOP LIMPING... STOP LIMPING! S – Septic Arthritis The most urgent part of our differential diagnosis. The hip is the most common joint affected, followed by the knee. Lab work can be helpful, as well as US of the hip to look for an effusion, but sometimes, regardless of the results, the joint just has to be tapped to know for sure. T – Toddler’s fracture This is usually a torque injury when the wobbling toddler pivots quickly or trips and falls. Toddler’s fractures happen in children 1 to 3 years of age, and occur in the distal 1/3 of the tibia. Sometimes a cast is needed, but currently there is a new trend in foregoing casting in mild cases. O – Osteomyelitis Bacteremia – from any source – can seed into any bone. It’s not very common, but it happens: approximately 2% of children who present to an ED with limp will have osteomyelitis. Plain films, ESR, and CRP are a fair screen to start. For more than the casual concern, MRI is the best modality to evaluate, followed by radionuclide scintigraphy. Although not the first choice modality, CT can show periosteal changes, such as inflammatory new bone formation or periosteal purulence. P – Perthes disease This is the famous Legg-Calvé-Perthes idiopathic avascular necrosis of the hip, usually affecting children from 3 to 12 years. They present with a slow onset pain and with an antalgic gait. Patients will have trouble with internal rotation and abduction of the hip. Radiographs may be initially normal. MRI can show the culprit: decreased perfusion to the femoral head and subsequent necrosis. L – Limb-Length Discrepancy Parents may notice that he seems “wobblier” than he should be. It may be that we are just now appreciating a congenital anomaly. Get out the paper tape, and measure from the anterior superior iliac spine to the medial malleolus and compare both sides. Children with limb-length discrepancy only need a non-urgent referral to pediatric orthopedics to look for congenital dysplasia of the hip, or other growth abnormalities. Some are treated with orthotics. Surgical options vary. Epiphysiodesis destroys the growth plate on the unaffected side, which evens out the growth. Other options are limb-lengthening or limb-shortening procedures. I – Inflammatory Transient Synovitis. This is what we want them to have right? The typical age is between 3 and 6 years, sometimes just after a URI. To be comfortable with this diagnosis, we should have considered all of the dangerous diagnoses, the child should be well, afebrile, in minimal discomfort, and he should respond almost completely to an NSAID. He’s the one running up and down the department after treatment – or just from sheer boredom after observation. M – Malignancy Primary bone tumors such as Ewing’s sarcoma or osteogenic sarcoma typically affect older children. Limping, however, may be a presenting symptom of leukemia. If you have any suspicion of the general wellness of the child, get a screening CBC, and perhaps a peripheral blood smear. Whatever you do, make sure you get close follow up for these kids that are on your malignancy radar -- the blast crisis may not have occurred yet – but it can happen hours to days later. Plain films are insensitive for leukemic involvement of bone but they may show diffuse osteopenia, or metaphyseal bands – symmetrical high-uptake markings around the joint. They look like stacks of paper within normal bone – you can see them also in anemia, lead poisoning, and other causes. Also look for periosteal new bone formation, sclerosis, or lysis. P – Pyomyositis This usually presents with vague irritability, pain, and fever, and sometimes with a subacute minor trauma. These children don’t look to well. Also think about just run-of-the-mill myositis, usually from a viral cause, such as influenza. Typically the calves are affected and are always tender. Hydration and supportive therapy are indicated for viral causes. For bacterial focal pyomyositis, give empiric antibiotics, admit them for major inpatient workup, and think about early surgical consultation if you think you need sepsis source control. I – Iliopsoas Abscess Children most often will develop a primary abscess from bacteremia from an unresolved infection. Adults more commonly form secondary abscesses from Crohn’s disease, post-op complications, a vertebral infection, or even a bad chronic urinary tract infection. Lest you think this is a dramatic presentation, think again: iliopsoas abscesses present also with vague symptoms of back, flank, abdominal, or hip pain, sometimes with fever. The median time from symptoms to diagnosis in children is a whopping 20+ days, according to one study. If iliopsoas abscess is starting to get your attention, get the CT or MRI. N – Neurologic Not to scare you, but children do have strokes; unlike adults, half are hemorrhagic, half are thromboembolic. Typically they’ll have some underlying pathology that will alert you, such as a cardiac lesion, sickle cell disease, or some infectious or metabolic history. The good news is that it won’t just be a limp – you’ll have some other neuro sign or symptom to go after. Guillain Barré is another thing to consider – early lower extremity weakness may present as a limp or refusal to walk. Maybe it’s not the hip that should be tapped, but the spinal canal. Think also about muscular dystrophy or peripheral neuropathy and its possible underlying etiology. G – Gastrointestinal and Genitourinary What else could be going on? Appendicitis may be faking you out here. Perhaps there is a hernia, or testicular or ovarian torsion, all of which can present as lateralizing pain and not wanting to walk. Think outside the box. Phases of Gait The gait cycle has three phases: contact, stance, and propulsion. Contact is the time from heel strike to just when the foot is flat. Stance is from the foot being flat to lifting the heel from the ground. The stance phase is when you bear most of your weight. The propulsion phase is when your weight transfers to your toes, and you push off. Abnormal Gaits Antalgic Gait -- "hobbling" gait; normal contact phase, but stance phase is abbreviated; propulsion is normal. The patient is trying to limit the time spent bearing weight on that side. Trendelenburg Gait -- the affected side's hip abductor muscles are too weak or painful to stabilize the pelvis; the unaffected side dips to the floor. May be superior gluteal neuropathy, or a biomechanical problem, such as avascular necrosis, congenital dysplasia of the hip, or slipped capital femoral epiphysis. Circumduction Gait -- the patient swings his foot laterally (due to a foot or ankle pathology), or to avoid tripping in limb-length discepancy. Stiff-leggged Gait -- the patient walks with knees locked, in an attempt to avoid using the gastrocnemius muscles; concerning for myositis. Equinus Gait -- toe-walking, as seen in myositis, also to avoid exacerbating pain from the calves. Lag of Internal Rotation of the Hip Look for symmetry of internal rotation, or lateralizing pain or "guarding" with range of motion. Keep the pelvis flush to the bed, and simultaneously rotate the lower extremity laterally, which will cause internal rotation of the hip. Avascular necrosis will not allow full internal rotation, since the joint space is narrowed with this maneuver, causing impingement of the sensitive necrotic head of the femur. Note any pain, asymmetry, and angle of internal rotation achieved. Kocher Criteria In their original paper in 1999, Dr Kocher et al. performed a retrospective analysis of children who were being evaluated for a septic joint versus transient synovitis over a 15 year period, in a major referral center. They came up with four independent predictors of a septic joint, and calculated the probability of septic arthritis based on the number of features present. In 2004 the same group validated their prediction tool, with a slightly decreased sensitivity and specificity in the validation population. In short, the Kocher criteria are not perfect, but it’s the best evidence we have at the moment. The four predictors are: Inability to walk Fever of 38.5 C of greater ESR > 40 mm/h WBC > 12,000 Bonus mnemonic: Walk FEW: Inability to Walk | Fever | ESR | WBC The probability of septic arthritis increases with increasing predictor. In this prediction model, each predictor has the same weight. Probability of Septic Arthritis (Kocher et al. 1999) 0 Predictor –
Mike Weinstock, MD and Mizuho Spangler, DO discuss fingernail pathologies, management of paronychia and risks for aggressive antibiotic usage in outpatient settings. PEARLS: Fingertip lesions can be isolated injuries or evidence of more serious, systemic processes. Radiographs of fingertips are useful if there is a concern for a retained foreign body, underlying fracture or deep-space infection like osteomyelitis. It is important to remember that nothing we do in medicine, including writing prescriptions and admitting patients to the hospital, is without risk, and we need to consider these risks in determining the right course of action for our patients. More information on this topic can be found on the Hippo Education blog here.
Taylor, G Evaluation Of The Chest Radiograph In Children With Known Or Suspected Heart Disease by OPENPediatrics
Questions? You can always contact us via our Contact Us page.
Questions? You can always contact us via our Contact Us page.
Prevalence of abnormal cases in an image bank affects the learning of radiograph interpretation - Martin V Pusic interview
Your pet is ill. You can't say exactly what is wrong, but you know there is a problem. Your veterinarian can be equally stumped. All the blood and urine tests are normal. Radiographs may show some areas of concern but they are not definitive. Sometimes the only way the diagnosis is made is after the pet dies and a post mortem is performed. The answer... cancer. Why couldn't it have been diagnosed earlier? With the discovery of biomarkers for some cancers, now a simple blood test may be able to save your pet's life. My guest is the President and Founder of Veterinary Diagnostics Institute, Randy Ringold. More details on this episode MP3 Podcast - Biomarkers -- What Are They and Could They Save Your Pet's Life....with Dr. Bernadine Cruz
Tierärztliche Fakultät - Digitale Hochschulschriften der LMU - Teil 05/07
Vertebral column stabilization is performed for dogs suffering from instability secondary to trauma, neoplasia, caudal cervical spondylomyelopathy, infection and other. A common stabilizing technique involves bicortical placement of positive profile end-threaded Steinman pins into the vertebral body and pedicles. Bicortical placement of these pins carries a high risk for iatrogenic trauma of important neurovascular structures. A clinical frustration has been the difficulty determining exact implant position based on postoperative conventional spinal survey radiographs. Implant position within the vertebral column may be better determined using a different imaging modality such as computed tomography as this would allow for evaluation of tissues in different anatomic planes. The goal of this study was to compare the accuracy of radiography and computed tomography in predicting implant position in relation to the vertebral canal in the cervical and thoracolumbar vertebral column in an in vitro imaging and anatomic study. Twelve medium-sized canine cadaver vertebral columns were utilized for this study. Steinman pins were placed into cervical and thoracolumbar vertebrae based on established landmarks but without predetermination of vertebral canal violation. Radiographs and CT exams were obtained and evaluated by 6 individuals. A random subset of pins was evaluated for ability to distinguish left from right pins on radiographs. The ability of the examiner to correctly identify vertebral canal penetration for all pins was assessed both on radiographs and CT. Spines were then anatomically prepared and visual examination of pin penetration into the canal served as the gold standard. Results revealed a left/right accuracy of 93.1%. Overall sensitivity of radiographs and CT to detect vertebral canal penetration by an implant were significantly different and estimated as 50.7% and 93.4%, respectively (P < 0.0001). Sensitivity was significantly higher for complete vs. partial penetration and for radiologists vs. non-radiologists for both imaging modalities. Overall specificity of radiographs and CT to detect vertebral canal penetration was 82.9% and 86.4%, respectively (P = 0.049). In conclusion, CT was superior to radiographic assessment and is the recommended imaging modality to assess penetration into the vertebral canal. The clinical relevance of this finding is that CT is significantly more accurate in identifying vertebral canal violation by Steinman pins and should be performed postoperatively to assess implant position.
This podcast highlights some useful soft tissue clues on conventional radiography that may help in the diagnosis of associated musculoskeletal disease. There is a mini-quiz at the end.
The second of a two-part review of some of the most important points in fractures and dislocations of the knee; there is a mini-quiz at the end
A two-part review of some of the most important points in fractures and dislocations of the knee
Learn how to localize objects on conventional radiographs by utilizing two images taken at a 90 degree angle to each other
Learn how the silhouette sign, one of the most fundamental in radiology, can enable you to locate a lesion and identify its density
How the 5 basic radiographic densities enable us to identify and locate an abnormality on conventional radiographs (plain films)