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  1. Article ; Online: Perforated Amyand hernia with an adenocarcinoma tumour presenting as a groin abscess.

    Gbegli, Emmanuel / Miremadi, Ahmad / Serrao, Eva Mendes / Sadler, Timothy J

    BJR case reports

    2024  Volume 10, Issue 2, Page(s) uaae008

    Abstract: An Amyand hernia is an incarcerated inguinal hernia containing the appendix with or without appendicitis. This is a rare form of inguinal hernia, making up approximately 0.4%-1% of all cases. As with any hernia, this may become strangulated at any time, ... ...

    Abstract An Amyand hernia is an incarcerated inguinal hernia containing the appendix with or without appendicitis. This is a rare form of inguinal hernia, making up approximately 0.4%-1% of all cases. As with any hernia, this may become strangulated at any time, leading to the loss of blood supply and further development of gangrene and complications. Clinically, this can present in a manner indistinguishable from other types of inguinal hernias. In addition, the appendix can be affected by its own set of pathological processes, such as infection, inflammation, and malignancy. Not uncommonly both hernial and appendiceal complications coexist. The clinical diagnosis of an Amyand hernia remains challenging due to its low incidence and indistinct clinical presentation. At present, surgery is usually diagnostic and therapeutic. However, there is a growing number of recent reports showing the invaluable role of imaging on the diagnosis of Amyand hernias and associated complications. The correct and timely recognition of their imaging features including complications can optimize and expedite patient care by guiding diagnosis, treatment, and prognosis. Here, we report for the first time the radiological and pathological findings of a patient with a unique complicated Amyand hernia, which posed a diagnostic challenge for the clinical and radiological teams.
    Language English
    Publishing date 2024-03-06
    Publishing country England
    Document type Case Reports
    ISSN 2055-7159
    ISSN (online) 2055-7159
    DOI 10.1093/bjrcr/uaae008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A painful swollen ankle after a fall.

    Sadler, Timothy J / Riede, Philipp

    BMJ (Clinical research ed.)

    2021  Volume 375, Page(s) n2315

    MeSH term(s) Accidental Falls ; Adult ; Ankle/pathology ; Ankle Injuries/etiology ; Ankle Injuries/pathology ; Ankle Joint/pathology ; Edema/etiology ; Edema/pathology ; Humans ; Male ; Medical Illustration ; Musculoskeletal Pain/etiology ; Musculoskeletal Pain/pathology ; Osteochondritis/etiology ; Osteochondritis/pathology
    Language English
    Publishing date 2021-10-28
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.n2315
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Incidence and distribution of injuries associated with e-scooter use: a radiological perspective.

    Bentham, Michael J / Christopher, Holly W / Borchert, Robin J / Thavakumar, Arthikkaa / Riede, Philipp / Sadler, Timothy J

    The British journal of radiology

    2024  Volume 97, Issue 1155, Page(s) 567–573

    Abstract: Objectives: To investigate electric scooter (e-scooter)-associated radiological injury incidence and distribution of injuries.: Methods: Retrospective cross-sectional study of radiological examinations related to e-scooter injuries at a major trauma ... ...

    Abstract Objectives: To investigate electric scooter (e-scooter)-associated radiological injury incidence and distribution of injuries.
    Methods: Retrospective cross-sectional study of radiological examinations related to e-scooter injuries at a major trauma centre in a small university city. The hospital radiology information system was searched for terms related to e-scooters between January 1, 2015, and October 31, 2022. E-scooter use was confirmed by review of the patients' electronic medical records. Specific injuries were divided based on site of injury using the Injury Severity Scale categorized groups.
    Results: A total of 568 radiological studies related to e-scooter injuries were identified on 340 distinct patients (56% male, with an average age of 28 years). Peak incidence of e-scooter-related injuries was seen in the summer months, after a local scooter sharing system was introduced in October 2020. A total of 149 patients had radiologically diagnosed injuries, with extremity injuries being most frequent (80%). Facial (8%), head/neck (8%), and thorax/abdomen (4%) were less common. Radial head fractures were the most common injury (n = 27). Thirteen patients had multiple sites of injury, four of which had both upper limb and facial bone fractures described.
    Conclusions: We report a significant increase in radiological investigations and injuries in the context of e-scooter injuries, particularly since the introduction of an e-scooter sharing scheme. This study informs radiologists on common locations of injuries when reporting studies of patients that have had e-scooter-related injuries.
    Advances in knowledge: This is the first UK-based study providing a comprehensive radiological perspective of the impact of e-scooter use and associated distribution of injuries, adding important data for many cities that are currently undertaking review of their e-scooter sharing schemes.
    MeSH term(s) Humans ; Male ; Adult ; Female ; Retrospective Studies ; Incidence ; Cross-Sectional Studies ; Radiography ; Trauma Centers ; Accidents, Traffic
    Language English
    Publishing date 2024-01-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2982-8
    ISSN 1748-880X ; 0007-1285
    ISSN (online) 1748-880X
    ISSN 0007-1285
    DOI 10.1093/bjr/tqad057
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Performance of ChatGPT on the Situational Judgement Test-A Professional Dilemmas-Based Examination for Doctors in the United Kingdom.

    Borchert, Robin J / Hickman, Charlotte R / Pepys, Jack / Sadler, Timothy J

    JMIR medical education

    2023  Volume 9, Page(s) e48978

    Abstract: Background: ChatGPT is a large language model that has performed well on professional examinations in the fields of medicine, law, and business. However, it is unclear how ChatGPT would perform on an examination assessing professionalism and situational ...

    Abstract Background: ChatGPT is a large language model that has performed well on professional examinations in the fields of medicine, law, and business. However, it is unclear how ChatGPT would perform on an examination assessing professionalism and situational judgement for doctors.
    Objective: We evaluated the performance of ChatGPT on the Situational Judgement Test (SJT): a national examination taken by all final-year medical students in the United Kingdom. This examination is designed to assess attributes such as communication, teamwork, patient safety, prioritization skills, professionalism, and ethics.
    Methods: All questions from the UK Foundation Programme Office's (UKFPO's) 2023 SJT practice examination were inputted into ChatGPT. For each question, ChatGPT's answers and rationales were recorded and assessed on the basis of the official UK Foundation Programme Office scoring template. Questions were categorized into domains of Good Medical Practice on the basis of the domains referenced in the rationales provided in the scoring sheet. Questions without clear domain links were screened by reviewers and assigned one or multiple domains. ChatGPT's overall performance, as well as its performance across the domains of Good Medical Practice, was evaluated.
    Results: Overall, ChatGPT performed well, scoring 76% on the SJT but scoring full marks on only a few questions (9%), which may reflect possible flaws in ChatGPT's situational judgement or inconsistencies in the reasoning across questions (or both) in the examination itself. ChatGPT demonstrated consistent performance across the 4 outlined domains in Good Medical Practice for doctors.
    Conclusions: Further research is needed to understand the potential applications of large language models, such as ChatGPT, in medical education for standardizing questions and providing consistent rationales for examinations assessing professionalism and ethics.
    Language English
    Publishing date 2023-08-07
    Publishing country Canada
    Document type Journal Article
    ISSN 2369-3762
    ISSN 2369-3762
    DOI 10.2196/48978
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Gastric volvulus causing liver ischemia.

    Rooney, Siobhan / Stavrou, George / Sadler, Timothy J / Oikonomou, Ilias-Marios / Gourgiotis, Stavros

    ANZ journal of surgery

    2023  Volume 93, Issue 11, Page(s) 2776

    MeSH term(s) Humans ; Stomach Volvulus/diagnosis ; Stomach Volvulus/diagnostic imaging ; Liver Diseases/complications ; Liver Diseases/diagnostic imaging ; Ischemia/etiology
    Language English
    Publishing date 2023-09-19
    Publishing country Australia
    Document type Letter
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/ans.18702
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  6. Article: Active pulmonary tuberculosis: something old, something new, something borrowed, something blue.

    Wetscherek, Maria T A / Sadler, Timothy J / Lee, Janice Y J / Karia, Sumit / Babar, Judith L

    Insights into imaging

    2022  Volume 13, Issue 1, Page(s) 3

    Abstract: Tuberculosis remains a major global health issue affecting all countries and age groups. Radiology plays a crucial role in the diagnosis and management of pulmonary tuberculosis (PTB). This review aims to improve understanding and diagnostic value of ... ...

    Abstract Tuberculosis remains a major global health issue affecting all countries and age groups. Radiology plays a crucial role in the diagnosis and management of pulmonary tuberculosis (PTB). This review aims to improve understanding and diagnostic value of imaging in PTB. We present the old, well-established findings ranging from primary TB to the common appearances of post-primary TB, including dissemination with tree-in-bud nodularity, haematogenous dissemination with miliary nodules and lymphatic dissemination. We discuss new concepts in active PTB with special focus on imaging findings in immunocompromised individuals. We illustrate PTB appearances borrowed from other diseases in which the signs were initially described: the reversed halo sign, the galaxy sign and the cluster sign. There are several radiological signs that have been shown to correlate with positive or negative sputum smears, and radiologists should be aware of these signs as they play an important role in guiding the need for isolation and empirical anti-tuberculous therapy.
    Language English
    Publishing date 2022-01-09
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2543323-4
    ISSN 1869-4101
    ISSN 1869-4101
    DOI 10.1186/s13244-021-01138-8
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  7. Article ; Online: Images of the month 2: Pulmonary artery pseudoaneurysm formation within uterine leiomyosarcoma metastases.

    Vaid, Divya / Majcher, Veronika / Heptonstall, Nicholas / Sadler, Timothy J / Winterbottom, Andrew P

    Clinical medicine (London, England)

    2021  Volume 21, Issue 5, Page(s) e533–e534

    Abstract: We present a rare case of pulmonary artery pseudoaneurysm formation in leiomyosarcoma metastases with evidence of acute bleeding and subsequent interventional radiological management. ...

    Abstract We present a rare case of pulmonary artery pseudoaneurysm formation in leiomyosarcoma metastases with evidence of acute bleeding and subsequent interventional radiological management.
    MeSH term(s) Aneurysm, False/diagnostic imaging ; Aneurysm, False/etiology ; Female ; Humans ; Leiomyosarcoma ; Middle Aged ; Pulmonary Artery/diagnostic imaging ; Uterine Neoplasms
    Language English
    Publishing date 2021-09-08
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2048646-7
    ISSN 1473-4893 ; 1470-2118
    ISSN (online) 1473-4893
    ISSN 1470-2118
    DOI 10.7861/clinmed.2021-0494
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Unexpected case of pneumomediastinum and subcutaneous emphysema: primary or secondary aetiology?

    Cheng, Amanda J L / Sadler, Timothy J

    BMJ case reports

    2018  Volume 2018

    Abstract: A 77-year-old man was admitted with a relapse of antineutrophil cytoplasmic antibody-positive vasculitis with pulmonary involvement and acute kidney injury. There was a background of pulmonary fibrosis (non-specific interstitial pneumonia type pattern) ... ...

    Abstract A 77-year-old man was admitted with a relapse of antineutrophil cytoplasmic antibody-positive vasculitis with pulmonary involvement and acute kidney injury. There was a background of pulmonary fibrosis (non-specific interstitial pneumonia type pattern) and superadded pulmonary haemorrhage, acute pulmonary oedema and sepsis. The patient was intubated for 4 days and remained dependent on high flow oxygen and continuous positive airway pressure after extubation. A chest radiograph performed 2 weeks after extubation demonstrated unexpected, extensive pneumomediastinum and subcutaneous emphysema. This was confirmed on CT which raised the possibility of a tracheal defect at the level of the prior endotracheal tube cuff position. Tracheal injury was considered clinically unlikely due to the considerable interval since extubation and a short, uneventful intubation period. The cardiothoracic team recommended a diagnostic bronchoscopy but this was felt too high risk by the clinical team. The cause of pneumomediastinum and subcutaneous emphysema remained indeterminate.
    MeSH term(s) Aged ; Airway Extubation/adverse effects ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/physiopathology ; Clinical Decision-Making ; Humans ; Male ; Mediastinal Emphysema/diagnostic imaging ; Mediastinal Emphysema/etiology ; Patient Care Management ; Pulmonary Edema/diagnosis ; Pulmonary Edema/etiology ; Pulmonary Fibrosis/diagnosis ; Pulmonary Fibrosis/etiology ; Radiography, Thoracic/methods ; Respiration, Artificial/methods ; Sepsis/diagnosis ; Sepsis/etiology ; Subcutaneous Emphysema/etiology ; Tomography, X-Ray Computed/methods ; Trachea/diagnostic imaging ; Trachea/injuries
    Language English
    Publishing date 2018-04-19
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2018-224528
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  9. Article ; Online: Placental MRI: Identification of radiological features to predict placental attachment disease regardless of reader expertise.

    Zawaideh, Jeries P / Freeman, Susan / Smith, Janette / Bruining, Annemarie / Sadler, Timothy J / Carmisciano, Luca / Addley, Helen C

    European journal of radiology

    2022  Volume 149, Page(s) 110203

    Abstract: Purpose: To compare the accuracy of placental MRI in reporting placental adhesive disease in readers with different expertise and to identify the most reliable MRI features that predict placental pathology regardless of reader expertise.: Methods: ... ...

    Abstract Purpose: To compare the accuracy of placental MRI in reporting placental adhesive disease in readers with different expertise and to identify the most reliable MRI features that predict placental pathology regardless of reader expertise.
    Methods: Retrospective analysis of 27 placental MRI studies by six radiologists with different expertise levels; specificity, sensitivity, and accuracy were used to quantify the predictive performance of eight radiological features previously described in the literature. Histopathological evaluation was used as a diagnostic gold standard when available and the presence of the radiological features was decided by consensus. Features with higher sensitivity and specificity were identified and the optimal cut-off was calculated to obtain the resulting accuracy.
    Results: The accuracy for seniors with expertise was non-statistically higher (0.83) compared to senior with no expertise (SWE) (0.65) and juniors (0.74) with SWE having tendency to over-estimate the severity of abnormality (26% vs 17%), whilst junior underestimated the degree of placental infiltration when compared to seniors with expertise (18.5% vs 0%, p = 0.006). Dark bands was the criteria with the highest sensitivity (95%) and high specificity (74%), followed by myometrial thinning (89%-76%) and uterine bulging (86%-81%). These three features demonstrated substantial (K) agreement. Using these features with optimal diagnostic cut-off, the accuracy increased to 0.91 for both the seniors and SWE and to 0.93 for the juniors.
    Conclusion: Placental MRI is most accurately interpreted by experienced radiologists; however, less experienced readers can obtain an accurate diagnosis relying on set criteria that are easier to be identified.
    MeSH term(s) Female ; Humans ; Magnetic Resonance Imaging/methods ; Placenta/diagnostic imaging ; Placenta/pathology ; Placenta Accreta/pathology ; Pregnancy ; Retrospective Studies ; Sensitivity and Specificity
    Language English
    Publishing date 2022-02-09
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 138815-0
    ISSN 1872-7727 ; 0720-048X
    ISSN (online) 1872-7727
    ISSN 0720-048X
    DOI 10.1016/j.ejrad.2022.110203
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  10. Article ; Online: Incidental coronary artery calcification on non-gated CT thorax correlates with risk of cardiovascular events and death.

    Wetscherek, Maria T A / McNaughton, Edwina / Majcher, Veronika / Wetscherek, Andreas / Sadler, Timothy J / Alsinbili, Ahmed / Teh, Wen Hui / Moore, Samuel D / Patel, Nirav / Smith, William P W / Krishnan, Unni

    European radiology

    2023  Volume 33, Issue 7, Page(s) 4723–4733

    Abstract: Objectives: To assess coronary artery calcification (CAC) on non-contrast non-ECG-gated CT thorax (NC-NECG-CTT) and to evaluate its correlation with short-term risk of cardiovascular disease (CVD) events and death.: Methods: Single-institution ... ...

    Abstract Objectives: To assess coronary artery calcification (CAC) on non-contrast non-ECG-gated CT thorax (NC-NECG-CTT) and to evaluate its correlation with short-term risk of cardiovascular disease (CVD) events and death.
    Methods: Single-institution retrospective study including all patients 40-70 years old who underwent NC-NECG-CTT over a period of 6 months. Individuals with known CVD were excluded. The presence of CAC was assessed and quantified by the Agatston score (CACS). CAC severity was defined as mild (< 100), moderate (100-400), or severe (> 400). CVD events (including CVD death, myocardial infarction, revascularisation procedures, ischaemic stroke, acute peripheral atherosclerotic ischaemia), and all-cause mortality over a median of 3.5 years were recorded. Cox proportional-hazards regression modelling was performed including CACS, age, gender and CVD risk factors (smoking, hypertension, diabetes mellitus, dyslipidaemia, and family history of CVD).
    Results: Of the total 717 eligible cases, 325 (45%) had CAC. In patients without CAC, there was only one CVD event, compared to 26 CVD events including 5 deaths in patients with CAC. The presence and severity of CAC correlated with CVD events (p < 0.001). A CACS > 100 was significantly associated with both CVD events, hazard ratio (HR) 5.74, 95% confidence interval: 2.19-15.02; p < 0.001, and all-cause mortality, HR 1.7, 95% CI: 1.08-2.66; p = 0.02. Ever-smokers with CAC had a significantly higher risk for all-cause mortality compared to never-smokers (p = 0.03), but smoking status was not an independent predictor for CVD events in any subgroup category of CAC severity.
    Conclusions: The presence and severity of CAC assessed on NC-NECG-CTT correlates with short-term cardiovascular events and death.
    Key points: • Patients aged 40-70 years old without known CVD but with CAC on NC-NECG-CTT have a higher risk of CVD events compared to those without CAC. • CAC (Agatston) score above 100 confers a 5.7-fold increase in the risk of short-term CVD events in these patients. • The presence and severity of CAC on NC-NECG-CTT may have prognostic and therapeutic implications.
    MeSH term(s) Humans ; Adult ; Middle Aged ; Aged ; Retrospective Studies ; Coronary Vessels ; Brain Ischemia ; Coronary Angiography/methods ; Risk Factors ; Risk Assessment ; Stroke ; Coronary Artery Disease/diagnostic imaging ; Tomography, X-Ray Computed ; Thorax ; Vascular Calcification/diagnostic imaging ; Prognosis
    Language English
    Publishing date 2023-01-27
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-023-09428-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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