Major Body Regions Research Articles

The skeletal taphonomy of anurans from the Eocene Geiseltal Konservat‐Lagerstätte, Germany: insights into the controls on fossil anuran preservation

AbstractThe Geiseltal biota is an Eocene lacustrine Konservat‐Lagerstätte in central Germany. Despite its rich fauna and flora (over 50 000 fossil vertebrates, insects and other invertebrates, plants and trace fossils) the taphonomy of the biota, and of the anurans in particular, is poorly understood. We analysed the skeletal taphonomy of 168 anurans, scoring each specimen for orientation, completeness and articulation. Most are partial skeletons, truncated during preparation. This process introduces measurable artefacts into the taphonomic data, which requires further study. We identified recurring taphonomic states, including disarticulation or loss of abdominal bones, loss of one or more limbs, extensive disarticulation, and extensive loss of elements across the body. Relatively rare states include: loss of distal limb elements only, scattered bones, and isolated, articulated limbs. These data inform a new taphonomic model for the Geiseltal anurans. Comparative analysis of patterns in completeness and articulation in these specimens and anurans from other Cenozoic Lagerstätten reveals repeated patterns in preservation in lacustrine‐hosted settings, such as proximal to distal trends in completeness, preferential loss of small peripheral bones, disarticulation of abdominal bones, and reorientation of major body regions. Taphonomic controls in lacustrine systems are surface water temperature, lake depth, vegetation, exposure to bottom currents, transport mechanisms, scavenging, decay regime, bone size and location in the skeleton; all ultimately controlled by palaeoclimate, lake physiography and hydrology, and anuran anatomy. A universal approach to quantitative analysis of skeletal taphonomy metrics will enable comparative testing of the relationship between preservation and palaeoenvironment for diverse fossil vertebrates.

Effect of physical activity intervention on the musculoskeletal health of university student computer users during homestay

Objectives. The coronavirus outbreak delivered the condition of dying from infection and forced people (especially university student computer users) to perform all working and non-working activities during homestay. In this situation, device usage for a longer duration is mainly responsible for work-related health issues. This study aims to discover the effect of a physical activity intervention (PAI) on computer users’ musculoskeletal health during homestay. Methods. The investigation was performed on 40 university student computer users. To measure body discomfort before and after using the PAI, the body part discomfort scale of Corlett and Bishop was applied. Results. After implementing the PAI, the musculoskeletal disorder (MSD) decrement in major body regions was reported as wrist/forearm (from 8.17 ± 1.45 to 4.57 ± 1.10), lower back (from 8.01 ± 1.42 to 4.40 ± 1.14), elbow (from 7.57 ± 1.71 to 3.49 ± 1.13) and neck (from 7.40 ± 1.71 to 4.02 ± 0.81). Conclusions. PAI significantly decreased the discomfort among users in various body regions. This research suggested that PAIs may reduce the risk of MSDs in the long term for different body regions.

Practical Computer Vision Application to Compute Total Body Surface Area Burn

Critical burn management decisions rely on accurate percent total body surface area (%TBSA) burn estimation. Existing %TBSA burn estimation models (eg, Lund-Browder chart and rule of nines) were derived from a linear formula and a limited number of individuals a century ago and do not reflect the range of body habitus of the modern population. To develop a practical %TBSA burn estimation tool that accounts for exact burn injury pattern, sex, and body habitus. This population-based cohort study evaluated the efficacy of a computer vision algorithm application in processing an adult laser body scan data set. High-resolution surface anthropometry laser body scans of 3047 North American and European adults aged 18 to 65 years from the Civilian American and European Surface Anthropometry Resource data set (1998-2001) were included. Of these, 1517 participants (49.8%) were male. Race and ethnicity data were not available for analysis. Analyses were conducted in 2020. The contributory %TBSA for 18 body regions in each individual. Mobile application for real-time %TBSA burn computation based on sex, habitus, and exact burn injury pattern. Of the 3047 individuals aged 18 to 65 years for whom body scans were available, 1517 (49.8%) were male. Wide individual variability was found in the extent to which major body regions contributed to %TBSA, especially in the torso and legs. Anterior torso %TBSA increased with increasing body habitus (mean [SD], 15.1 [0.9] to 19.1 [2.0] for male individuals; 15.1 [0.8] to 18.0 [1.7] for female individuals). This increase was attributable to increase in abdomen %TBSA (mean [SD], 5.3 [0.7] to 8.7 [1.8]) among male individuals and increase in abdomen (mean [SD], 4.6 [0.6] to 6.8 [1.7]) and pelvis (mean [SD], 1.5 [0.2] to 2.9 [0.9]) %TBSAs among female individuals. For most body regions, Lund-Browder chart and rule of nines estimates fell outside the population's measured interquartile ranges. The mobile application tested in this study, Burn Area, facilitated accurate %TBSA burn computation based on exact burn injury pattern for 10 sex and body habitus-specific models. Computer vision algorithm application to a large laser body scan data set may provide a practical tool that facilitates accurate %TBSA burn computation in the modern era.

Body and Wing Allometries Reveal Flight-Fecundity Tradeoff in Response to Larval Provisioning in Osmia lignaria (Hymenoptera: Megachilidae).

Variation in body size has important implications for physical performance and fitness. For insects, adult size and morphology are determined by larval growth and metamorphosis. Female blue orchard bees, Osmia lignaria, (Say) provision a finite quantity of food to their offspring. In this study, we asked how provision-dependent variation in size changes adult morphology. We performed a diet manipulation in which some larvae were starved in the final instar and some were given unlimited food. We examined the consequences on adult morphology in two ways. First, allometric relationships between major body regions (head, thorax, abdomen) and total body mass were measured to determine relative growth of these structures. Second, morphometrics that are critical for flight (wing area, wing loading, and extra flight power index) were quantified. Head and thorax mass had hyperallometric relationships with body size, indicating these parts become disproportionately large in adults when larvae are given copious provisions. However, abdominal mass and wing area increased hypoallometrically with body size. Thus, large adults had disproportionately lighter abdomens and smaller wing areas than smaller adults. Though both males and females followed these general patterns, allometric patterns were affected by sex. For flight metrics, small adults had reduced wing loading and an increased extra flight power index. These results suggest that diet quantity alters development in ways that affect the morphometric trait relationships in adult O. lignaria and may lead to functional differences in performance.

Primary Management of Polytrauma

The management of polytrauma patients is a challenging and dynamic process for the whole multidisciplinary team in the emergency department. Decisions made and measures taken during primary management have the ultimate effect on the prognosis of multiple injured patients. Trauma team leaders and team members benefit from a structured approach to such a complex situation. Hospital-specific interdisciplinary consensus on the workflow can help to optimize the management of trauma patients. All medical specialties involved should therefore have a basic understanding of each other’s approaches and the treatment options of the most important injury patterns. Primary Management of Polytrauma aims to provide a systematic and comprehensive guide on how to identify treatment options of potentially life-threatening injuries. The editors, all 3 themselves experienced surgeons from the Republic of South Korea, gathered authors from several surgical disciplines to cover sections on injuries of all major body regions. These specific sections are preceded by 2 sections on “Initial Assessment and Management” and the “Management of Shock,” which are authored by an emergency physician and 2 acute care surgeons. The book ends with 2 chapters on the role of radiology and a section on when and how to transfer trauma patients from your hospital. Within its 183 pages, the book provides a lot of detailed surgical information on how to diagnose and to classify individual injuries and gives insights into the regional approach of the management of trauma patients. Unfortunately, these sections do not intersect with each other, and there exists no overriding framework. Therefore, the book falls short to be a structured step-to-step guide to the management of polytrauma patients. Especially during the primary management of multiple injured patients, anticipation of injury mechanisms, pathophysiology of injury-related diseases (ie, trauma-associated coagulopathy), and critical injury constellations are crucial points. Unfortunately, none of these problems are substantially discussed in the book. The authors do not mention internationally accepted course concepts like the European Trauma Course (ETC) or Advanced Trauma Life Support (ATLS), both of which offer possibilities to learn trauma management in a structured manner. The views of international guidelines are rarely reflected in the book. In the chapter “Management of Shock,” recommendations on hemostatic resuscitation include the immediate transfusion of packed red blood cells; fresh-frozen plasma; platelets; and the correction of the lethal triad of coagulopathy, hypothermia, and acidosis. Lots of such improvident advice can be found throughout the first 2 chapters. For massive transfusion situations, for example, it is stated that (Chapter 2, page 14) “Current data support a target ratio of plasma:red blood cell:platelet transfusions of 1:1:1.” No advice on how to adjust transfusion on laboratory measures or the potential problems that come with transfusing large amounts of plasma is mentioned. The “current data” cited in the reference list, however, were published between 1982 and 2010, although more recent and high-quality evidence would have been available in most cases.1 Cited references in the short section discussing coagulopathy even go back to 1982–1989 (Chapter 2, page 14). More importantly, the book is lacking high-evidence recommendations from international consensus guidelines, like the early application of tranexamic acid to the bleeding trauma patient to treat or prevent hyperfibrinolysis.2 Specific chapters provide more detailed information on the classification and the surgical approach to the respective injuries. Radiological images and the discussion of relevant clinical scoring systems (as can be found in Chapter 4, “Spinal Injuries”) can support the physician’s individual decision-making. However, in most cases, these decisions would not be made by the leader or a member of the trauma team during the initial management of the patient. This is rather a surgical specialist’s task. In summary, this book allows for detailed insight into parts of the surgical decision-making and the approach to specific injuries and injury patterns of the polytraumatized patient. This can be interesting additional information for the advanced trauma leader or interested members of the trauma team. Due to lack of evidence-based information and missing recommendations from current guidelines, we cannot recommend the book as a guide or a reference for studying the primary management of polytrauma patients. Nils Kunze-Szikszay, MDKonrad Meissner, MDKlinik für AnästhesiologieUniversitätsmedizin GöttingenGöttingen, Germany[email protected]

Neural ensemble dynamics in dorsal motor cortex during speech in people with paralysis.

Speaking is a sensorimotor behavior whose neural basis is difficult to study with single neuron resolution due to the scarcity of human intracortical measurements. We used electrode arrays to record from the motor cortex 'hand knob' in two people with tetraplegia, an area not previously implicated in speech. Neurons modulated during speaking and during non-speaking movements of the tongue, lips, and jaw. This challenges whether the conventional model of a 'motor homunculus' division by major body regions extends to the single-neuron scale. Spoken words and syllables could be decoded from single trials, demonstrating the potential of intracortical recordings for brain-computer interfaces to restore speech. Two neural population dynamics features previously reported for arm movements were also present during speaking: a component that was mostly invariant across initiating different words, followed by rotatory dynamics during speaking. This suggests that common neural dynamical motifs may underlie movement of arm and speech articulators.

Do Social and Environmental Factors Affect the Emergency Service Admission Characteristics of Preschool-Aged Pediatric Trauma Patients?: A Prospective Study.

Studies related to the epidemiology of trauma play a major role in determining the health status of the communities living in the vicinity of the centers that they are conducted. We have found no epidemiological study related to emergency service admission conducted only on preschool-aged children in the literature. Our aim was to determine characteristics of trauma in this age group, to analyze encountered trauma types, and to investigate possible associations among epidemiological factors, characteristics of the trauma victims, and trauma itself in pediatric patients admitted to our emergency service. We conducted a prospective study with patients aged 66 months and younger, admitted to Emergency Service of Istanbul Kanuni Sultan Suleyman Training and Research Hospital between July 1, 2015, and December 31, 2015. Data related to age, sex, occupational status of parents, number of siblings, Glasgow coma scale score, transport mode, admission time period of the day, general health status, type of trauma, the trauma site, involved body regions, radiologic imaging and laboratory results, consultations, clinical diagnosis and outcome, duration of emergency service stay, and treatment cost were collected and statistically analyzed. A total of 688 preschool-aged cases were admitted owing to trauma. The major mode of transport was a private vehicle (98.3%), and the major cause was falling (64.0%). The major traumatized body region was head and neck (51.0%), and the major diagnosis was soft tissue trauma (90.1%). The average duration of stay was 122.01 minutes and affected by sibling number, trauma type, and employment status. The total service fee was interrelated with the type of trauma and the site that trauma occurred; it also was strongly correlated with duration of emergency service stay. Our results suggest that both in-hospital and social/environmental aspects should be improved to reduce the clinical and social burden of trauma.

Multiple-Site Pain in Fibromyalgia- A Confirmatory Factor Analysis

Fibromyalgia is a highly heterogeneous disorder occurring as widespread pain associated with general symptoms such as fatigue, depression, anxiety, insomnia, sexual dysfunction, and gastrointestinal conditions. This cross-sectional single tertiary medical center survey study aimed to investigate how multiple pain sites contribute to the construct of general pain in fibromyalgia. Altogether 266 women with fibromyalgia aged 18 to 60 years were included in the analysis. Confirmatory factor analysis of pain severity measured by a visual analogue scale (0 to 100 points) in seven major body regions. Headache, low back pain, and neck pain explained most of the total variance in general pain perceived across seven different body regions. Substantial correlations of 0.71, 0.68, and 0.61 were found between general pain and headache, low back pain, and neck pain, respectively. Pain reported for other four regions (chest, abdomen, upper extremity, and lower extremity) demonstrated fair correlations with general pain. When experiencing multi-site pain, women with fibromyalgia perceived headache, low back pain, and neck pain being subjectively more important than pain in other sites. While pain intensity and location commonly varies in fibromyalgia patients, it is important that one is aware of most common sites to be able to recognize fibromyalgia so that it can be managed properly.

Measurement of epidermis, dermis, and total skin thicknesses from six different body regions with a new ethical histometric technique

Introduction: Although it is important to know the normal values of dermis, epidermis, or total skin thicknesses (ST) for some drugs and vaccine research, skin‑related clinical investigations, and skin transfer operations used in plastic surgery, it would not be ethical to take new biopsies from healthy volunteers to measure their ST. This study aims to describe a new ethical histometric technique for the measurement of skin layers and to determine the mean ST of some major body regions in the people living in our region. Materials and Methods: A total of 180 skin samples from six major body regions of 90 males and 90 females were enrolled in the study. The measurements were performed histometrically from appropriate skin samples obtained from the pathology archive. The samples were classified according to the six different parts of the body (scalp, abdomen, back, dorsum of foot, dorsum of hand, and the breast). Results: The mean epidermal thickness ranged from 76.9 ± 26.2 to 267.4 ± 120.6 μm. The thickest epidermis was found in the dorsum of foot in women (267.4 ± 120.6 μm) while the thinnest was found in the breast in women (76.9 ± 26.2 μm). The mean dermal thickness ranged from 2115 ± 946.4 to 5888 ± 2422.3 μm. The thickest dermis was found in the breast in men (5888 ± 2422.3 μm), while the thinnest dermis was found in the dorsum of hand in women (2115 ± 946.4 μm). Conclusions: Human ST varies according to ethnic origin. It was determined that the dermis and epidermis of Anatolian people are thicker than that of the previously reported other ethnic groups. The skin pathology archive can be used to create maps of the body’s skin structure. Keywords: Dermis, epidermis, histometric, skin thickness

WORK-RELATED MUSCULOSKELETAL DISORDERS: AN ERGONOMIC INTERVENTION PROGRAM AMONG AL-AHRAR HOSPITAL INTENSIVE CARE UNITS NURSES

Introduction: Work-related Musculoskeletal Disorders are common among healthcare workers especially nurses, and because they are preventable, attention should be raised towards the importance of training as the first step for improving both health of nurses and quality of patient care thus decreasing both human and economic costs. Aim of work: This study was conducted to assess the prevalence of workrelated musculoskeletal disorders, to implement an ergonomic training program and to evaluate the effect of ergonomic intervention program nurses’ physical workload and work style. Materials and methods: intensive care units’ nurses from two hospitals participated in the study and completed questionnaires including Nordic musculoskeletal questionnaire, physical work load questionnaire and Workstyle Short Form questionnaire. An intervention training program was conducted in one hospital on ergonomic principles, musculoskeletal disorders, patient manual-handling techniques, stretching and relaxation exercises for major body regions, other hospital regardedas control. Evaluation of the effect of the program was conducted after 6 months. Results: Low back pain was the commonest cause of job change among intervention and control hospitals nurses (11.9%, 13.0% respectively). Most of nurses reported a moderate physical workload. There was significant reduction in physical work load and improvement in the Work style after intervention (p < 0.001). Conclusion: Considering the fact of decreased resources needed to equip the Egyptian hospitals with advanced patient handling equipment and as a glance of hope to improve nurses’ health and safety while performing their job, our ergonomic training program showed significant improvement in nurses’ activities that will help in reducing Work-related Musculoskeletal Disorders (WRMSDs) and thus improvement of their quality of life.

A PERFECT END: A STUDY OF SYLLABLE CODAS IN SOUTH AFRICAN SIGN LANGUAGE

South African Sign Language (SASL) is an understudied language with a rich and interesting phonology. For instance, while the language allows onsetless syllables, it does not allow codaless syllables, except in a small class of signs which do not include path movement. This article identifies and defines possible constraints on syllable codas in SASL. Using a video dictionary as data, we have coded handshapes at locations occurring at the onset and coda of the more common signs in the lexicon. In handshape, it has been found that the selected fingers may move to create different handshapes in the coda position, but that these coda handshapes are often [1], [5], [A], [A] or [S], which are the unmarked handshapes of the non-dominant hand in asymmetrical two-handed signs (Sandler and Lillo-Martin 2006). Furthermore, the joint specification for the selected fingers can also vary in the coda position, but there appear to be strict limitations on which joint combinations are permitted in the onset-coda relationship. There are also constraints on coda location. The major body region can change within a single syllable, and the preferred body regions in the coda position are [body] and [H2]. It is evident not only that handshape and location constraints occur at the coda position, but that these constraints show patterns similar to coda neutralisation in many spoken languages.

Observation of Grooming Behaviour in Wild Capped Langur Trachypithecus pileatus

The manual dexterity of primates allows them to use their hands to clean their skin and hairs as well as maintain a good social relationship with intra-group members. This behaviour is described as grooming. It is the most common affinitive behaviour among primates and may be directed to the self (Autogrooming) or with a intra-group member (Allogrooming or social grooming). Auto-grooming is often determined by the site accessibility, while social grooming is concentrated on parts inaccessible to the groomee. In this paper, we have recorded the grooming behaviour and patterns in capped langur (Trachypithecus pileatus) in Pakke Wildlife Sanctuary, Arunachal Pradesh, India. Focal-animal sampling technique was adopted for recording the grooming behaviour. The following behavioural observations in relation to time spent on grooming, grooming bouts and length, and grooming site preference are studied with the aim to assess the diurnal active time spent on grooming patterns of capped langurs. Of the 1683 hrs of observation, T. pileatus spent totally 60.95 hrs in grooming behaviours including 32.9 hrs (54%) for social grooming and 28.1 hrs (46%) for auto-grooming. A total of 1934 grooming bouts were recorded during the observation period. Of these, 58% bouts were for auto-grooming followed by 42% for social grooming. Maximum (15 min) grooming bout length was recorded in social grooming prior to copulation in compare to auto-grooming (8 min). Seven major body regions namely dorsal, ventral, lateral, ano-genital, face and head, tail and hind limbs were frequently observed to be groomed by capped langur. Of the total social grooming bouts (817), maximum (30%) was estimated on the dorsal side followed by 23% on ventral side, 21% on ano-genital region, 14% on lateral side, and 11% on face and head. Social grooming is adopted as tool to manipulate reproductive behaviour and to formulate survival strategies of the species.

Radiological Anatomy Daily Lab Slides for Medical Gross Anatomy Courses

Abstract This resource contains six PowerPoint presentations corresponding to the six major human body regions with labeled radiological anatomy structures and answer explanations designed for use ...

Trends in Diagnostic CT Among Fee-For-Service Enrollees, 2000-2011

To examine trends in the use of diagnostic CT in aggregate and for 4 major body regions (abdomen/pelvis, head/neck, chest, and spine) in an 11-year US nationwide analysis. We summarize records from a large, mostly fee-for-service insurance claims database from 2000 to 2011. Rates of diagnostic CT have increased substantially from 2000 to 2011; however, changes in rates are disparate for different age groups and body regions. As others have shown, there has been a notable increase in use of diagnostic CT from 2000 to 2011. However, from 2009 to 2011, diagnostic CT studies of the chest, abdomen/pelvis, and head/neck have leveled off or decreased, whereas CTs of the spine show a continued increase in many groups. In general, the increase in the rate of CT study performance has slowed, whereas spine CT continued to escalate. Future research should consider whether the increase in use of spine CT leads to a benefit that outweighs the risk associated with the increased population-level cancer risk.

Pangolin expression influences the development of a morphological novelty: Beetle horns

Morphological diversity arises during development through the actions and interactions of diverse developmental pathways. Among those, the Wnt pathway is known to contribute to diverse developmental processes such as segmentation and the morphogenesis of appendages. Here, we characterize a transcription factor in the Wnt pathway, pangolin (pan), to investigate the role of Wnt signaling in the development of evolutionarily novel body structures: the horns of beetles. Beetle horns are highly diverse in size, shape, and number and develop principally from two major body regions: the head and prothorax. We investigate horns in two species of the genus Onthophagus using comparative in situ hybridization, larval RNA interference, and allometric measurements to analyze whether horn formation is regulated by pan and by extension the Wnt pathway. Our results illustrate that pan expression affects beetle horn growth in a species-, sex-, and location-specific manner in two morphologically distinct, yet closely-related, Onthophagus species.

Died of Wounds on the Battlefield: Causation and Implications for Improving Combat Casualty Care

Understanding the epidemiology of death after battlefield injury is vital to combat casualty care performance improvement. The current analysis was undertaken to develop a comprehensive perspective of deaths that occurred after casualties reached a medical treatment facility. Battle injury died of wounds (DOW) deaths that occurred after casualties reached a medical treatment facility from October 2001 to June 2009 were evaluated by reviewing autopsy and other postmortem records at the Office of the Armed Forces Medical Examiners (OAFME). A panel of military trauma experts classified the injuries as nonsurvivable (NS) or potentially survivable (PS), in consultation with an OAFME forensic pathologist. Data including demographics, mechanism of injury, physiologic and laboratory variables, and cause of death were obtained from the Joint Theater Trauma Registry and the OAFME Mortality Trauma Registry. DOW casualties (n = 558) accounted for 4.56% of the nonreturn to duty battle injuries over the study period. DOW casualties were classified as NS in 271 (48.6%) cases and PS in 287 (51.4%) cases. Traumatic brain injury was the predominant injury leading to death in 225 of 271 (83%) NS cases, whereas hemorrhage from major trauma was the predominant mechanism of death in 230 of 287 (80%) PS cases. In the hemorrhage mechanism PS cases, the major body region bleeding focus accounting for mortality were torso (48%), extremity (31%), and junctional (neck, axilla, and groin) (21%). Fifty-one percent of DOW casualties presented in extremis with cardiopulmonary resuscitation upon presentation. Hemorrhage is a major mechanism of death in PS combat injuries, underscoring the necessity for initiatives to mitigate bleeding, particularly in the prehospital environment.

Osteoderms of Simosuchus clarki (Crocodyliformes: Notosuchia) from the Late Cretaceous of Madagascar

ABSTRACT The pug-nosed crocodyliform Simosuchus clarki is known from several specimens that collectively preserve, in addition to the skull and postcranial endoskeletal elements, a complete complement of osteoderms covering every major body region. This comprehensive sample of osteoderms facilitates the reconstruction, from multiple sources, of the entire postcranial dermal skeleton of this crocodyliform. In this contribution, I describe the anatomy, arrangement, and histology of the osteoderms of S. clarki, and provide comments on the phylogenetic and functional importance of these structures. As in other crocodyliforms, the osteoderms of Simosuchus were organized into discrete ‘shields’ covering the dorsal and ventral regions of the trunk and tail. Simosuchus also exhibited extensive osteodermal coverage of the limbs, a feature that characterizes very few crocodyliforms. The osteoderms from different shields possess distinctive morphological features, allowing isolated osteoderms to be assigned accurately to their respective shields. Paleohistological investigations reveal porous, lightly built osteoderms overlying dorsal and appendicular regions, and gastral osteoderms with a flat, diploe-like structure. Details about growth and longevity in Simosuchus are equivocal when assessed using data from osteoderms alone. Simosuchus possessed a tetraserial paravertebral shield, with at least four accessory parasagittal rows of osteoderms on either side. Sagittal segmentation probably enhanced flexibility with respect to ancestral crocodyliforms, but the presence of numerous, tightly sutured accessory rows suggests that lateral undulation, and therefore swimming, was likely restricted. Several new morphological characters are described here, and it is proposed that these will be informative in future studies of crocodyliform phylogeny.

CT dose reduction is achievable: one site's experience with a dose optimisation process

AbstractAn Emotion 6 Siemens Multi‐Detector CT scanner (Erlangen, Germany) was installed at the review site in December 2005. Improving upon the manufacturer's default exposure settings, the authors sought to perform a quality review to reduce ionising radiation dose delivered to patients. Dose associated with CT examinations across the major body regions was assessed. Dose savings ranged from 11% to 70% when compared to the manufacturer's default settings. Dose comparisons are also made with the European Standards and the United Kingdom Field Survey.

Diagnostic and Interventional Musculoskeletal Ultrasound: Part 2. Clinical Applications

Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurological and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared to other available imaging modalities; (2) describe how ultrasound machines produce images using sound waves; (3) discuss the steps necessary to acquire and optimize an ultrasound image; (4) understand the difference ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones; and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound. Part 2 of this 2-part article will focus on the clinical applications of musculoskeletal ultrasound in clinical practice, including the ultrasonographic appearance of normal and abnormal tissues as well as specific diagnostic and interventional applications in major body regions.

HSP60 and Anti-HSP60 Antibodies in Vasculitis: They are Two of a Kind

Clinical and pathological manifestations present as heterogeneous in vasculitides. Thus, inflammation can affect arteries, arterioles, capillaries, venules, and veins toward major body regions. One common feature of vascular diseases appears to be the presence of anti-HSP60 autoantibodies arising either consecutively to infection and molecular mimicry reaction with bacterial HSP60, or following recognition of endogenous HSP60 translocated or bound onto the surface of stressed endothelial cells. Because their levels are very low in some diseases but strikingly upregulated in others, and because their frequencies vary from one vasculitis to another, anti-HSP60 autoantibodies might play a role in the pathological mechanisms that likely differ among the vascular diseases. Identification of the variety of HSP60 epitope specificities along with each vasculitis would help to understand such discrepancies.