The use of computed tomography attenuation to evaluate osteoporosis following acute fractures of the thoracic and lumbar vertebra.

BACKGROUND: Relatively few patients have dual-energy x-ray absorptiometry to quantify the magnitude of bone loss as they age. Recent work correlates mean computed tomography (CT) attenuation in the level I (L1) vertebra with bone mineral density (BMD), making it possible to objectively evaluate the magnitude of bone loss in osteoporosis by this method. The aims of this study were to evaluate the utility of using CT scans in patients with acute thoracic and lumbar spine fractures to diagnose osteoporosis and using CT attenuation to evaluate the association between age and BMD. METHODS: We performed a retrospective study of patients with acute fractures of the thoracic or lumbar spine who had also undergone an abdominal (or L1) CT scan and compared mean CT attenuation in L1 against threshold values. We also compared differences in CT attenuation between younger (<65 years) and older (≥65 years) and older patients. RESULTS: A total of 124 patients were evaluated (74 thoracic and 50 lumbar fractures). Overall, there was a strong correlation between age and bone density as measured by CT attenuation (r = -.76). Among those with thoracic fractures (<65 years), mean CT attenuation was 196.51 HU. Forty-one patients were ≥65 years and had mean CT attenuation of 105.90 HU (P < .001). In patients with lumbar fractures, 27 patients were <65 years and had a mean CT attenuation of 192.26 HU and 23 patients were ≥65 years and had mean CT attenuation of 114.31 HU (P < .001). At the threshold of 110 HU, set for specificity, the magnitude of difference between the age-stratified cohorts was greater in the thoracic spine (P < .0001 vs P = .003). DISCUSSION: Using opportunistic CT, we demonstrate the relative frequency of osteoporosis in patients with acute fractures of the thoracic and lumbar spine and confirm that the association increases with age. The CT attenuation may provide a cheap and convenient method to help confirm a clinical diagnosis of osteoporosis in patients with fractures.

Parents' reports predict abnormal investigations in global developmental delay.

AIMS: To identify symptoms reported by parents that predict abnormal laboratory investigations in preschoolers with global developmental delay (GDD). METHODS: A cross-sectional descriptive study of 81 boys and 38 girls, with a mean age of 43.5 months (SD = 13.4), with global developmental delay. All parents/guardians completed the following: (1) a semistructured interview about their child and family; (2) the Child Development Inventory (CDI); (3) the Possible Problems Checklist (PPC); and (4) the Child Behavior Checklist 1(1/2)-5 (CBCL). RESULTS: There were 61 abnormal results: MRI 37 (31%); high-resolution chromosomes 8 (7%); fragile X molecular testing 4 (3%); and microarray comparative genomic hybridization 12 (10%). A total of 47 children had abnormal tests (40%): none, 72 (60%); one, 36 (30%); two, 8 (7%); three, (3%). Younger children with more developmental delays are more likely to have abnormal tests. They are clumsy, more passive, and less disobedience. They had lower total, externalizing, and internalizing problems scores. The odds of finding an abnormal investigation are increasingly greater as parent's report of language comprehension and social development ratios increase, and decrease in likelihood for every increase in the expressive language and fine motor ratios. INTERPRETATION: Parent's reports predict abnormal tests and indicate quantifiable differences requiring investigation.

Cuestionario de personalidad eficaz para la formación profesional / Efficient personality questionnaire for profesional training

Este estudio se enmarca dentro del ámbito teórico del constructo «Personalidad eficaz». Se presenta el estudio de validez interna y fiabilidad de un cuestionario en su origen compuesto por 60 ítems aplicado a estudiantes de los ciclos formativos de grado superior de Formación Profesional, reducido finalmente a 24 ítems, superando su inicial coeficiente alfa de Cronbach de 0,84. Se obtienen seis factores de primer orden: autoconcepto social, autoconcepto académico, capacidad resolutiva, autoestima, expectativa de éxito y afrontamiento de problemas. Se obtiene un único factor de segundo orden denominado «Personalidad eficaz». La solución factorial de seis componentes presenta similitud tanto con la versión española para secundaria como las versiones chilena para poblaciones de secundaria y universitaria, diversificando la inicial dimensión de autoconcepto en autoconcepto y autoestima (AU)

This study falls within the theoretical framework of the construct of the Efficient Personality. In this work, we present the study of validity and reliability of an original questionnaire made up of 60 items, applied to students from formative cycles of higher Profesional Training. The questionnaire was reduced to 24 items, surpassing its initial .84 Cronbach alpha coefficient. Six first-order factors were obtained: Social Self-concept, Academic Self-concept, Solving Ability, Self-esteem, and Problem Coping. One second-order factor was obtained: Efficient Personality. The six-component factorial solution is similar both to the Spanish version for secondary school and to the Chilean versions for secondary and university populations, dividing the initial dimension of Self-concept into Self-concept and Self-esteem (AU)

Multi-section CT angiography for detection of cerebral aneurysms.

BACKGROUND AND PURPOSE: Multi-section CT has great potential for use in vascular studies. Our purpose was to determine the accuracy of multi-section CT angiography in detecting cerebral aneurysms compared with digital subtraction angiography or surgery. METHODS: One hundred consecutive patients who underwent multi-section CT angiography and either digital subtraction angiography or surgery were included in the study. Multi-section CT angiography and digital subtraction angiography results were evaluated independently by different neuroradiologists who performed aneurysm detection, quantitation, and characterization by using 2D multiplanar reconstructions, 3D maximum intensity projection, and volume-rendered techniques. RESULTS: When using intra-arterial digital subtraction angiography or surgery, 113 aneurysms (true positives and false negatives) were detected in 83 of the 100 patients. A total of 106 aneurysms (true positives) were confirmed by using digital subtraction angiography or surgery, or both. Seven aneurysms were missed when using multi-section CT angiography. Eight aneurysms were not confirmed by digital subtraction angiography and were considered to be false positive evaluations. The sensitivity for detecting aneurysms < 4 mm, 4 to 10 mm, and > 10 mm on a per-aneurysm basis was 0.84 (95% confidence interval: 0.72, 0.92), 0.97 (95% confidence interval: 0.91, 0.99), and 1.00 (95% confidence interval: 0.88, 1.00), respectively. The sensitivity, specificity, and accuracy of multi-section CT angiography for detecting aneurysms on a per-patient basis were 0.99 (95% confidence interval: 0.96, 1.00), 0.88 (95% confidence interval: 0.69, 0.94), and 0.98 (95% confidence interval: 0.95, 1.00), respectively. CONCLUSION: Multi-section CT angiography has a high sensitivity in detecting aneurysms (especially aneurysms > 3 mm). However, CT angiography is currently not sensitive enough to replace digital subtraction angiography.