Explore the vast range of titles available.

Objectives: The aim of this study was to determine differences in injury types and frequencies between piston-based and band-based automated chest compression devices in patients with non-traumatic out-of-hospital cardiac arrest (OHCA) at a German cardiac arrest center. Methods: This retrospective single-center study assessed resuscitation-related injuries in OHCA patients using protocol-based early whole-body CT scans at hospital admission. CT scans were reviewed independently by two reviewers blinded to the compression device used. Between May 2015 and September 2021, all patients resuscitated from non-traumatic OHCA, treated with a mechanical chest compression device, and showing stable return of spontaneous circulation (ROSC) until CT examination according to the institutional standard operating procedure for all OHCA patients were included. Patients were categorized by compression device type, and group differences were analyzed using the Chi-square test and Mann–Whitney U test. In addition, patient-level incidences of rib fracture types were calculated, and risk ratios with corresponding 95% confidence intervals were used to compare rib fracture patterns between groups. A p-value of <0.05 was considered statistically significant. Results: Among 71 patients, 32 received band-based and 39 piston-based treatment. Both groups were comparable in resuscitation duration, body constitution, and gender ratio, although the band-based group was older. Thoracic injuries predominated, with rib fractures representing the most frequent injury pattern (64/71, 90.1%). The median number of rib fractures per patient was 10 (IQR 8–12) in the band-based group and 9 (IQR 7–12) in the piston-based group. The band-based group had significantly more liver lacerations (5/32, 15.6% vs. 0/39, 0%; p = 0.01) and displaced rib fractures (117 vs. 87; p = 0.046; patient-level RR = 1.43, 95% CI 1.06–1.93). Conclusions: In this observational study of a CT-based cohort of OHCA patients with stable ROSC, the band-based device was associated with significantly higher frequencies of liver lacerations and displaced rib fractures than the piston-based device. These findings should be interpreted as hypothesis-generating and may support further evaluation of device-specific injury profiles in future studies.

Multiple studies show orthopedic health problems for medical staff due to wearing radiation protection aprons. The aim of this study was to evaluate the weight pressure on the shoulder as a marker of physical strain caused by different radiation-protection devices. For the weight pressure measurement, a pressure sensor (OMD-30-SE-100N, OptoForce, Budapest, Hungary) placed on the left and right shoulder was used. Wearing different radiation protection systems the force measurement system was used to quantify the weight pressure. Measurements were acquired in still standing position and during various movements. A mean significant decreasing weight pressure on the shoulder between 74% and 84% (p<0.001) was measured, when the free-hanging radiation protection system was used in comparison to one-piece and two-piece radiation protection aprons and coats. Using two-piece radiation protection aprons, the weight pressure was significantly lower than that of one-piece radiation protection coats. If a belt was used for the one-piece radiation protection coat, the weight pressure on the shoulder was reduced by 32.5% (p = 0.003). For a two-piece radiation protection apron and a one-piece radiation protection coat (with and without belt) a significant different weight pressure distribution between the right and left shoulder could be measured. The free-hanging radiation protection system showed a significant lower weight pressure in comparison to the other radiation protection devices. Apart from this, use of a two-piece radiation protection apron or addition of a belt to a radiation protection coat proved to be further effective options to reduce weight pressure.

Background: Hypoxic-ischemic brain injury (HIBI) is a feared complication post-cardiac arrest (CA). The timing of brain imaging remains a topic of ongoing debate. Early computed tomography (CT) scans can reveal acute intracranial pathologies but may have limited predictive value due to delayed manifestation of HIBI-related changes. Radiomics analyses present a promising approach to identifying subtle imaging markers, potentially aiding early HIBI detection. Methods: This study retrospectively assessed post-CA patients between 2016 and 2023 who received immediate brain CTs. Patients without acute intracranial pathology on initial scans and who underwent follow-up brain CTs within 14 days post-return of spontaneous circulation (ROSC) were included. Image segmentation involved manual basalganglia segmentation and automated whole-brain segmentation. Radiomics features were calculated using Pyradiomics (v3.0.1) in 3DSlicer (v5.2.2). Feature selection involved reproducibility analysis via ICC and LASSO regression, retaining five features per segmentation method. A logistic regression model for each segmentation method underwent 5-fold cross-validation. Results were summarized with ROC analyses and average sensitivity and specificity. Results: A total of 83 patients (average age: 65 ± 13.3 years, 19 women) with CA and ROSC were included. Follow-up CT scans after 5.2 ± 2.9 days revealed brain edema in 47 patients. The model using manual segmentation achieved an average AUC of 0.76, sensitivity of 0.59, and specificity of 0.78. The automated segmentation model showed an average AUC of 0.66, sensitivity of 0.49, and specificity of 0.68. Conclusions: Radiomics, particularly focused on the basalganglia area in normal-appearing brain CTs after CA and ROSC, may enhance predictive insights for HIBI and the development of brain edema.

Purpose This study explores the utility of the large language models, GPT-3 and GPT-4, for in-depth patient education prior to interventional radiology procedures. Further, differences in answer accuracy between the models were assessed. Materials and methods A total of 133 questions related to three specific interventional radiology procedures (Port implantation, PTA and TACE) covering general information as well as preparation details, risks and complications and post procedural aftercare were compiled. Responses of GPT-3 and GPT-4 were assessed for their accuracy by two board-certified radiologists using a 5-point Likert scale. The performance difference between GPT-3 and GPT-4 was analyzed. Results Both GPT-3 and GPT-4 responded with (5) “completely correct” (4) “very good” answers for the majority of questions ((5) 30.8% + (4) 48.1% for GPT-3 and (5) 35.3% + (4) 47.4% for GPT-4). GPT-3 and GPT-4 provided (3) “acceptable” responses 15.8% and 15.0% of the time, respectively. GPT-3 provided (2) “mostly incorrect” responses in 5.3% of instances, while GPT-4 had a lower rate of such occurrences, at just 2.3%. No response was identified as potentially harmful. GPT-4 was found to give significantly more accurate responses than GPT-3 ( p  = 0.043). Conclusion GPT-3 and GPT-4 emerge as relatively safe and accurate tools for patient education in interventional radiology. GPT-4 showed a slightly better performance. The feasibility and accuracy of these models suggest their promising role in revolutionizing patient care. Still, users need to be aware of possible limitations. Graphical Abstract

Purpose The study aims to show how the “Puncture Cube” (PC) (Medical Templates, Egg, Switzerland) compares to the freehand method (FHM) for CT-guided punctures. Methods The PC is a patient-mounted disassemblable cube consisting of an upper and lower template with multiple holes each to predefine puncture trajectory. A total of 80 punctures (FHM in-plane, FHM off-plane, PC in-plane, PC off-plane) was performed by 4 radiologists on a target 9.1 cm below surface level of a neoprene covered elliptical cylinder gelatin phantom. The PC was never disassembled. Evaluated parameters were procedure time, number of CT-scans, euclidean distance (ED) and normal distance (ND). Respective parameters of FHM and PC were compared using the Wilcoxon signed-rank test and Levene test with significance levels of 5%. Results PC achieved smaller ED and ND values after initial needle insertion without corrections for both in-plane and off-plane punctures ( P  > 0.05). Variance of initial NDs was off-plane significantly larger for FHM. Final ED after needle path corrections was smaller for FHM both in- and off-plane ( P  < 0.05). Final off-plane ND was significantly lower for FHM with no significant difference in final in-plane ND. FHM off-plane punctures were significantly faster. There was no significant difference in CT-scans between both methods. Conclusion Utilizing the PC may improve initial needle positioning and safety especially off-plane. However, better final needle positioning after correction with the greater freedom of movement method may suggest need for disassembly of the cube Graphical Abstract

HintergrundTraumatische Verletzungen der peripheren Gefäße betreffen zu etwa einem Drittel die oberen Extremitäten und zu zwei Dritteln die unteren Extremitäten. Traditionell wurden diese Verletzungen operativ behandelt. Zunehmend kommen auch interventionelle Therapietechniken wie Embolisation oder die Implantation von Stent-Grafts zum Einsatz.FragestellungDerzeitiger Stand von Diagnostik und interventionellen Therapieoptionen peripherer arterieller Gefäßverletzungen.Material und MethodeAnhand einer selektiven Literaturrecherche wird der aktuelle Stand des interventionellen Managements peripherer Gefäßverletzungen dargestellt.ErgebnisseDie berichteten klinischen Erfahrungen sind zwar spärlich, bestätigen aber durchgehend die Effektivität dieser Behandlungsansätze. Trotz verbesserter Technik und Materialien sind allerdings nicht alle Patienten und Verletzungsmuster für eine interventionelle Therapie geeignet. Dementsprechend ist eine individuelle, interdisziplinäre Indikationsstellung erforderlich.SchlussfolgerungDen positiven klinischen Daten entsprechend sollte eine interventionelle Therapie peripherer Gefäßverletzungen öfter als bisher erwogen und Behandlungsalgorithmen sollten entsprechend angepasst werden.

ZusammenfassungHintergrundTraumatische Verletzungen der peripheren Gefäße betreffen zu etwa einem Drittel die oberen Extremitäten und zu zwei Dritteln die unteren Extremitäten. Traditionell wurden diese Verletzungen operativ behandelt. Zunehmend kommen auch interventionelle Therapietechniken wie Embolisation oder die Implantation von Stent-Grafts zum Einsatz.FragestellungDerzeitiger Stand von Diagnostik und interventionellen Therapieoptionen peripherer arterieller Gefäßverletzungen.Material und MethodeAnhand einer selektiven Literaturrecherche wird der aktuelle Stand des interventionellen Managements peripherer Gefäßverletzungen dargestellt.ErgebnisseDie berichteten klinischen Erfahrungen sind zwar spärlich, bestätigen aber durchgehend die Effektivität dieser Behandlungsansätze. Trotz verbesserter Technik und Materialien sind allerdings nicht alle Patienten und Verletzungsmuster für eine interventionelle Therapie geeignet. Dementsprechend ist eine individuelle, interdisziplinäre Indikationsstellung erforderlich.SchlussfolgerungDen positiven klinischen Daten entsprechend sollte eine interventionelle Therapie peripherer Gefäßverletzungen öfter als bisher erwogen und Behandlungsalgorithmen sollten entsprechend angepasst werden.