University of Iowa Hospitals and Clinics

About: University of Iowa Hospitals and Clinics is a healthcare organization based out in Iowa City, Iowa, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 7201 authors who have published 9476 publications receiving 276995 citations. The organization is also known as: University of Iowa Hospitals & Clinics.

Prospective comparative study of intermediate-field MR and CT in the evaluation of closed head trauma.

Abstract: Forty patients with closed head trauma were evaluated prospectively with CT and intermediate-field-strength MR imaging to compare the diagnostic efficacies of the two techniques. Traumatic lesions were detected in 38 patients. The severity of injury, as determined by the Glascow Coma Scale, ranged from 3 to 14. The sensitivities of CT and MR were calculated for all subgroups of lesions: (1) hemorrhagic and nonhemorrhagic intraaxial lesions (diffuse axonal injury, cortical contusion, subcortical gray-matter injury, primary brainstem injury); (2) extraaxial hematomas (subdural, epidural); and (3) diffuse hemorrhage (subarachnoid, intraventricular). CT and MR (T1- and T2-weighted) studies were both highly and comparably sensitive in the detection of hemorrhagic intraaxial lesions. MR scans, however, were much more sensitive in detecting nonhemorrhagic lesions. cortical contusions and diffuse axonal injury constituted 91.9% of all intraaxial lesions. The sensitivities of the imaging techniques for this combined group of lesions were (1) nonhemorrhagic lesions (CT = 17.7%, T1-weighted MR = 67.6%, T2-weighted MR = 93.3%); (2) hemorrhagic lesions (CT = 89.8%, T1-weighted MR = 87.1%, T2-weighted MR = 92.5%). MR was also significantly better in detecting brainstem lesions (CT = 9.1%, T1-weighted MR = 81.8%, T2-weighted MR = 72.7%). The sensitivities of the diagnostic studies in the detection of extraaxial hematomas were CT = 73.2%, T1-weighted MR = 97.6%, T2-weighted MR = 90.5%). Intraventricular hemorrhage was consistently seen with all three imaging studies, but subarachnoid hemorrhage was detected much more frequently with CT. In summary, MR has clear advantages over CT in evaluating closed head trauma. Although its sensitivity in detecting hemorrhagic lesions is similar to that of CT, it is much better than CT in detecting nonhemorrhagic lesions, which are more prevalent. MR is more useful than CT in classifying primary and secondary forms of injury and directing treatment. CT's one advantage over MR is its ability to more rapidly assess unstable patients who may need surgery.

Cocaine-induced Myocardial Infarction in Patients with Normal Coronary Arteries

Abstract: ▪Objective:To review the reported cases of myocardial infarction temporally related to recreational and topical anesthetic use of cocaine, with special regard for underlying etiologic fact...

Articular Fractures: Does an Anatomic Reduction Really Change the Result?*

Abstract: The effects of injury to the articular cartilage sustained during articular fracture and the effect of treatment interventions on joint function and preservation are poorly understood. Surgeons do not have good data on which to base treatment decisions, and widely held beliefs are not always supported by data. Which fractures benefit from surgery to restore the articular surface? To what degree does the articular surface need to be reduced to predict a favorable outcome? How can we accurately assess the amount of displacement? What is the effect of the articular injury compared with residual displacement on the eventual outcome? These questions were addressed at a symposium presented at the Annual Meeting of the American Orthopaedic Association in June 2001. The evidence to answer the question that was raised in the title of the symposium-"Does an anatomic reduction really change the result?"-is not necessarily adequate. The purpose of the symposium, on which this article is based, was to explore the current state of our knowledge of basic and clinical research on articular fractures. In the process, important unanswered questions were identified and an agenda for meaningful research was developed. To accomplish these goals, the basic-science studies on articular cartilage injury, incongruity, and the capacity for remodeling were reviewed. The ability to accurately measure the articular reduction, which is critical to clinical research, was assessed, and clinical data for four representative articular fractures-those of the tibial plateau, acetabulum, distal aspect of the radius, and tibial plafond-are described. Together the data on these four fractures fairly represent what generally is and is not known about outcomes of articular fractures. The data challenge the widely held assumption that the quality of the reduction is closely associated with the outcome. Areas requiring additional research are defined. ### Effects of Articular Injury On the basis of the type of tissue damage, …