Brain Imaging in Adolescents and Young Adults With First-Episode Psychosis: A Retrospective Cohort Study.

OBJECTIVE: Despite the lack of clear guidelines, neuroimaging (computed tomography [CT] or magnetic resonance imaging [MRI]) is frequently performed in subjects presenting with first-episode psychosis (FEP). The objective of this study was to determine if the use of neuroimaging adds diagnostic yield in adolescents and young adults presenting with FEP. METHODS: The sample consisted of 443 subjects aged 15-24 with FEP (DSM-IV-TR and DSM-5) and no focal neurologic findings. Consecutive charts from January 1, 1998, to June 30, 2016, were reviewed retrospectively. A positive finding was defined as a result leading to urgent follow-up or intervention. RESULTS: Twenty-five (5.6%) of 443 subjects showed incidental findings unrelated to psychosis. The prevalence of positive findings from neuroimaging was 0%, indicating no diagnostic yield from neuroimaging. CONCLUSIONS: Routine neuroimaging did not provide diagnostic information leading to a change in clinical management and should not be recommended in the investigation of FEP.

Combined cementoplasty and radiofrequency ablation in the treatment of painful neoplastic lesions of bone.

PURPOSE: To assess the safety and effectiveness of combined radiofrequency (RF) ablation and cementoplasty in the treatment of painful neoplastic lesions of bone. MATERIALS AND METHODS: The authors performed a retrospective analysis of 25 combined treatments comprising RF ablation followed by injection of polymethylmethacrylate cement performed in 19 patients during a 22-month period. Patients ranged in age from 42 to 82 years (mean, 58.9 years) and included five women and 14 men. Eleven vertebrae (eight lumbar and three thoracic), nine acetabulae, three sacra, one pubis, and one humerus were treated with a total of 36 RF ablations (in several instances, overlapping ablations were used). The location of the primary neoplasm, lesion size, pain before and after the procedure (as determined with a 10-point visual analog scale [VAS]), number of RF treatments, type of device used for cementoplasty, RF time, cement volume, and extravasation were documented. RESULTS: A total of 25 combined RF ablations and cementoplasties were performed. The technical success rate was 100% (25 of 25 treatments). There were seven minor complications: six limited cement extravasations and a transient thermal nerve injury. The mean RF time was 9.1 minutes (range, 6-12 minutes). The mean cement volume injected was 6.1 mL (range, 0.8-16 mL). The mean preprocedure pain (as measured with a VAS) was 7.9 (range, 7.0-9.0) and the mean posttreatment pain was 4.2 (range, 0-6); the difference was statistically significant (mean score, 4.08; 95% confidence interval: 3.92, 4.87; P < .0001) using a paired t test. CONCLUSIONS: Combined RF ablation and cementoplasty appears to be safe and effective in the treatment of painful neoplastic lesions of bone.