Computed Tomography in Emergency Diagnosis and Management Considerations of Small Bowel Obstruction for Surgical vs. Non-surgical Approach.

BACKGROUND: Background: Small Bowel Obstruction (SBO) accounts for 15% of abdominal pain complaints referred to emergency departments and imposes significant financial burdens on the healthcare system. The most common symptom and sign of SBO is the absence of stool or flatus passsage and abdominal distension, respectively. Patients who do not demonstrate severe clinical or imaging findings are typically treated with conservative approaches. Patients with clinical signs of sepsis or physical findings of peritonitis are often instantly transferred to the operating room without supplementary imaging assessment. However, in cases where symptoms are non-specific or physical examination is challenging, such as in cases with loss of consciousness, the diagnosis can be complicated. This paper discusses the key findings identifiable on Computed Tomography (CT) which are vital for the emergent triage, proper treatment and appropriate decision making in patients with suspected SBO. METHODS: Narrative review of the literature. RESULTS: CT plays a key role in emergent triage, proper treatment and decision making and provides high sensitivity, specificity, and accuracy in the detection of early-stage obstruction and acute intestinal vascular compromise. CT can also differentiate between various etiologies of SBO entity which is considered an important criterion in the triage of patients into surgical vs. non-surgical treatment. CONCLUSION: There Key CT findings which may suggest a need for surgical treatment include mesenteric edema, lack of the small-bowel feces, bowel wall thickening, fat stranding in the mesentery, and intraperitoneal fluid which are predictive of urgent surgical exploration.

Gender Disparity in Radiology Society Committees and Leadership in North America and Comparison With Other Continents.

PURPOSE: To evaluate gender distribution in radiology professional society leadership positions. Our study intends to assess and compare the gender distribution among leadership roles and professional society committee memberships of the radiology societies and seek an understanding of potential associations between gender, academic research metrics, institutional academic rank, and leadership roles. METHODS: We identified radiology professional society committee members to assess relative gender composition in 28 radiology societies in North America, Europe, and Australia/New Zealand. The research metrics were obtained from the SCOPUS database and demographics and institutional affiliation through institutional websites' internet searches. Gender distribution by academic ranks and other discontinuous variables were analyzed using the Chi-Square test. Wallis tests. RESULTS: Of the 3011 members of society committees, 67.9% were male, and 32.1% female. Among all the society members, the data showed that the proportion of committee members holding leadership positions was comparable between males (25.7%) and females (22.5%). However, when we did a subgroup analysis and disaggregated the data by leadership positions, we noted that among those who held the leadership positions, the proportion of males was more significant (n = 526, 70.7%) compared to females (n = 218, 29.3%). Overall, males had higher median publications, citations, H-indices, and active years of research (P< 0.0001). At all university academic ranks, men outnumbered females (P = 0.0015, Chi-square 15.38), with the most considerable disparity at the rank of professor (71.9% male, 28.1% female, P = 0.0003). CONCLUSION: There was male predominance amongst committee members in radiology societies. Our study found no significant differences between those in leadership positions, suggesting that once a member of a committee, females are equally likely as males to attain leadership positions. Analysis of committee members' academic rank and committee leaders demonstrated underrepresentation of females at higher academic ranks, and males overall had higher research metrics than females.

Responding to coronavirus disease 2019: LA County hospital experience.

The coronavirus disease 2019 (COVID-19) has rapidly spread across the world since first being identified in Wuhan, China, in late 2019. In order to prepare for the surge of patients and the corresponding increase in radiology exams, clear and detailed policies need to be implemented by hospitals and radiology departments. In this article, we highlight the experiences and policies at LAC+USC Medical Center, the largest single provider of healthcare in LA County. Our policies aim to reduce the risk of transmission, guide patient management and workflow, preserve and effectively allocate resources, and be responsive to changing dynamics. We hope this communication may help other institutions in dealing with this pandemic as well as future outbreaks.

Lack of Gender Disparity Among Administrative Leaders of Canadian Health Authorities.

Background: Gender distribution within the managing bodies of the Canadian health authorities has not been studied despite their integral role in the health care system. The purpose of this study is to quantify gender differences and to craft a geographic gender analysis of such distribution. Methods: Retrospective data collection of all Canadian health authorities at the provincial, territorial, regional, and first nations levels was conducted. The dependent variable was gender, and other covariates, where applicable, included province/territory, region, leadership position, education (PhD or Master's), honorary degree, and primary occupation. Any member within the executive managing body or board of directors of a Canadian health authority was included, unless their gender could not be determined, in which case they were excluded. Results: Quantitative analysis of the 67 health authorities revealed 1346 individuals with identifiable gender (710 women; 636 men). Thematic distribution showed no significant difference in the gender distribution by provinces/territories (chi square = 14.248; p = 0.28), by leadership position (chi square = 1.88; p = 0.75), by education (chi square = 1.85; p = 0.17), or by primary occupation (chi square = 1.53; p = 0.46). Conclusion: The overall number of females exceeded that of males and there were no gender disparities. Critical analysis of probable causes was discussed. Further studies should be conducted to examine the policies and programs within the Canadian health authorities that successfully tackle the retention, recruitment, and promotion of females.

Leadership Gender Disparity Within Research-Intensive Medical Schools: A Transcontinental Thematic Analysis.

BACKGROUND: The underrepresentation of women in senior leadership positions of academic medicine continues to prevail despite the ongoing efforts to advance gender parity. Our aim was to compare the extent of gender imbalance in the leadership of the top 100 medical schools and to critically analyze the contributing factors through a comprehensive theoretical framework. METHODS: We adopted the theoretical framework of the Systems and Career Influences Model. The leadership was classified into four tiers of leadership hierarchy. Variables of interest included gender, h-index, number of documents published, total number of citations, and number of years in active research. A total of 2448 (77.59%) men and 707 (22.41%) women met the inclusion criteria. RESULTS: Male majority was found in all regions with a significant difference in all levels of leadership (chi square = 91.66; P value = .001). Women had a lower mean h-index across all positions in all regions, and when we adjusted for number of years invested, M Index for women was still significantly lower than men (T test = 6.52; P value = .02). DISCUSSION: Organizational and individual influences are transcontinental within the top 100 medical school leadership hierarchy. Those factors were critically assessed through in-depth analysis of the Systems and Career Influences Model. Evidence-driven actionable recommendations to remedy those influences were outlined.

Gender disparity in academic emergency radiology.

OBJECTIVE: This study is intended to better understand how academic productivity and career advancement differs between men and women emergency radiologists in academic practices. MATERIALS AND METHODS: Parameters of academic achievement were measured, including number of citations, number of publications, and h-index, while also collecting information on academic and leadership ranking among emergency radiologists in North America. RESULTS: In emergency radiology, there are significantly fewer women than men (22.2% vs 77.8%). Of these women, the greatest proportion of women held the lower academic rank of assistant professor (95.4%). Female assistant professors had a higher h-index than men at the same rank (4 vs 2), but it was not statistically significantly higher. There was no significant difference between gender and academic (p = 0.089) or leadership (p = 0.586) rankings. CONCLUSION: This study provides further evidence that gender disparity persists in emergency radiology, with women achieving less upward academic career mobility than men, despite better academic productivity in the earlier stages of their careers. The academic productivity of emergency radiologists at the rank of assistant professor is significantly higher for women than men.

Advanced Musculoskeletal Applications of Dual-Energy Computed Tomography.

Dual-energy CT (DECT) is a rapidly growing tool in musculoskeletal radiology. It has been validated as an accurate imaging modality for the assessment of gout and bone marrow edema. DECT can be used to reduce metal artifacts. A few studies have shown its ability to calculate bone mineral density and examine pathologic states in tendons and ligaments. Its capacity for material separation suggests its emergence as a technique for arthrography, and for the evaluation of intervertebral discs and other inflammatory arthropathies.

Gender Differences in the Publication Rate Among Breast Imaging Radiologists in the United States and Canada.

OBJECTIVE: The purpose of this study is to determine whether academic achievement differs by gender among breast imaging radiologists. MATERIALS AND METHODS: We examined the gender disparity in academic breast radiology using several parameters, including the h-index, the number of publications, and the number of citations. We also inspected gender disparity in academic ranks and leadership ranks. RESULTS: The research productivity of female breast imagers was found to be significantly lower than that of male colleagues across all academic ranks (p < 0.001). In addition, no correlation was noted between female gender and leadership positions (p = 0.57), despite the fact that women dominate the specialty of breast imaging. CONCLUSION: The number of publications by female radiologists has risen steadily over time; however, a significant gender disparity is seen in scholarly productivity.