Continuous Publishing articles

[Online Only] Radiologic and Clinical Findings of Behcet Disease: Comprehensive Review of Multisystemic Involvement

2008-07-06

Behçet disease is a chronic, relapsing, systemic disorder of unknown etiology, characterized by recurrent oral and genital ulcers, uveitis, and other clinical manifestations in multiple organ systems. Although the diagnosis is made on the basis of the combination of typical clinical symptoms, radiologic findings of Behçet disease show characteristic features of its involvement in the gastrointestinal, neurologic, cardiovascular, and thoracic organ systems. In the gastrointestinal tract, Behçet disease may produce various types of ulcers in the esophagus, stomach, and small and large intestines, as well as deeply penetrating ulcerations in the ileocecal region, with frequently accompanying enteric fistulas. Neurologic involvement includes typical and atypical parenchymal neurobehcet disease, dural sinus thrombosis, cerebral arterial aneurysm, occlusion, dissection, and meningitis. Vascular involvement is divided into three subsets including venous occlusion, arterial occlusion, and arterial aneurysm. Cardiac manifestations include intracardiac thrombus, endomyocardial fibrosis, periaortic pseudoaneurysm, and rupture of the sinus of Valsalva. Manifestations of Behçet disease in the thorax include pulmonary arterial aneurysm, pulmonary arterial thromboembolism, thrombosis in the superior vena cava, pulmonary infarction, hemorrhage, and vasculitis of the pleura and pericardium. These various manifestations of Behçet disease respond to steroid treatment; however, one of the characteristics of Behçet disease is the high rate of complications and recurrence after surgery. Familiarity with its various radiologic and clinical characteristics is essential in making an accurate early diagnosis and for prompt treatment of patients with Behçet disease.

[Informatics] Informatics in Radiology: An Inexpensive Distance Learning Solution for Delivering High-Quality Live Broadcasts

Jeun, B. S., Javan, R., Gay, S. B., Olazagasti, J. M., Bassignani, M. J. — 2008-07-06

Providing an adequate method of distance learning is a challenge faced by many multicenter residency programs. The delivery of live didactics over the Internet is a convenient means of providing a uniform and equivalent educational experience to residents at distant sites. An application called MedCast has been developed with use of existing technologies, without the need for costly commercial products or equipment. MedCast captures the presenter’s computer screen and audio from a microphone source to produce a streaming video that is transmitted online and archived on a local server. Offsite residents can view broadcasts in real time or access archived conference sessions for later viewing. MedCast is available for download at no cost and offers several advantages, including a user-friendly graphical display interface, near-perfect preservation of image quality, and cost efficiency. Future plans include objective assessment of the efficacy of MedCast by comparing postlecture examinations to help evaluate for any differences between on- and offsite residents in terms of knowledge gained. A movie clip to supplement this article is available online at http://radiographics.rsnajnls.org/cgi/content/full/285085701/DC1.

[Quality Initiatives] Managing an Acute Adverse Event in a Radiology Department

Kruskal, J. B., Siewert, B., Anderson, S. W., Eisenberg, R. L., Sosna, J. — 2008-07-06

Many local and national regulatory organizations require that all serious adverse events be promptly investigated, managed, and reported, with the first goal being to institute actions to prevent or minimize the occurrence of similar events. However, the tools and processes necessary for effective incident review and management have been developed largely by industrial organizations, and radiologists may not be familiar with such processes. Data analysis requires a root cause analysis to identify all possible active and latent contributors to the event, as well as the use of algorithms to determine the degree of responsibility when human error is implicated. Acceptable corrective actions that are reasonable, achievable, and measurable should be instituted. These changes should be monitored according to defined timelines by a designated person. In some cases, additional training or even remediation may be required. Subsequently, the focus should be on actively managing and improving error detection and reporting systems, as well as on seeking strategies for minimizing the occurrence of preventable errors.