RESUMEN
We report a case of an adolescent who presented with a deep vein thrombosis (DVT) and clinical findings consistent with May-Thurner Syndrome. Specific imaging demonstrated direct compression of the left common iliac vein by an overlying pelvic kidney. The patient's history and clinical presentation is detailed. The discussion focuses on the potential implications for care and management of a patient with an ectopic left pelvic kidney.
Asunto(s)
Enfermedades Renales/diagnóstico por imagen , Enfermedades Renales/etiología , Riñón/diagnóstico por imagen , Síndrome de May-Thurner/complicaciones , Síndrome de May-Thurner/diagnóstico por imagen , Adolescente , Anticoagulantes/uso terapéutico , Humanos , Masculino , Síndrome de May-Thurner/tratamiento farmacológico , Flebografía , Ultrasonografía , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/tratamiento farmacológico , Trombosis de la Vena/etiologíaRESUMEN
RATIONALE AND OBJECTIVES: The Socratic method has long been a traditional teaching method in medicine and law. It is currently accepted as the standard of teaching in clinical wards, while the didactic teaching method is widely used during the first 2 years of medical school. There are arguments in support of both styles of teaching. MATERIALS AND METHODS: After attending a radiology conference demonstrating different teaching methods, third-year and fourth-year medical students were invited to participate in an online anonymous survey. RESULTS: Of the 74 students who responded, 72% preferred to learn radiology in an active context. They preferred being given adequate time to find abnormalities on images, with feedback afterward from instructors, and they thought the best approach was a volunteer-based system of answering questions using the Socratic method in the small group. They desired to be asked questions in a way that was constructive and not belittling, to realize their knowledge deficits and to have daily pressure to come prepared. The respondents thought that pimping was an effective teaching tool, supporting previous studies. CONCLUSIONS: When teaching radiology, instructors should use the Socratic method to a greater extent. Combining Socratic teaching with gentle questioning by an instructor through the use of PowerPoint is a preferred method among medical students. This information is useful to improve medical education in the future, especially in radiology education.
Asunto(s)
Educación de Pregrado en Medicina , Radiología/educación , Estudiantes de Medicina/psicología , Enseñanza/métodos , Humanos , AprendizajeRESUMEN
BACKGROUND: Nasal continuous positive airway pressure (CPAP) has been used since 1975 as the initial treatment for respiratory distress syndrome (RDS) in very premature infants. Gaseous distention of the abdomen (CPAP belly) is a common secondary effect of CPAP. Gaseous distention of the hypopharynx is also common. OBJECTIVE: To determine the incidence of hypopharyngeal distention in infants on CPAP. MATERIALS AND METHODS: We performed a retrospective review of the chest radiographs of 57 premature infants treated with CPAP during a 4-week period to find the presence and degree of hypopharyngeal distention. RESULTS: Of the 57 radiographs, 14 (25%) revealed gaseous distention of the hypopharynx and/or cervical esophagus. On occasion, this raised concern for pharyngeal perforation or esophageal atresia. CONCLUSION: Awareness that CPAP-related hypopharyngeal distention is common should help radiologists avoid erroneous consideration of esophageal atresia or hypopharyngeal perforation.
Asunto(s)
Presión de las Vías Aéreas Positiva Contínua/efectos adversos , Atresia Esofágica/diagnóstico , Esófago/patología , Hipofaringe/patología , Enfermedades Faríngeas/diagnóstico , Diagnóstico Diferencial , Dilatación Patológica/etiología , Atresia Esofágica/epidemiología , Atresia Esofágica/terapia , Esófago/diagnóstico por imagen , Humanos , Hipofaringe/diagnóstico por imagen , Incidencia , Recién Nacido , Recien Nacido Prematuro , Recién Nacido de muy Bajo Peso , Unidades de Cuidado Intensivo Neonatal , Enfermedades Faríngeas/congénito , Enfermedades Faríngeas/epidemiología , Enfermedades Faríngeas/terapia , Radiografía , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
"Hair-on-end" skull changes resembling thalassemia were rarely described in the 1950s and 1960s in children with cyanotic congenital heart diseases; these changes were described almost entirely in patients with tetralogy of Fallot or D-transposition of the great arteries. As these lesions have become correctable, the osseous changes, never common, seem now only to exist in a small number of patients with uncorrectable complex cyanotic congenital heart disease who survive in a chronic hypoxic state. We present two cases: a case of marked marrow expansion in the skull of a 5-year-old boy with uncorrectable cyanotic heart disease studied by CT, and a second case of an 8-year-old with tetralogy of Fallot and pulmonary atresia studied by plain skull radiographs. The true incidence of these findings is unknown.