A displaced bronchus branching from the left main bronchus and bifurcating into the apicoposterior and anterior bronchi of the left upper lobe in a healthy adult male: A case report.

A displaced left upper bronchus is a rare anomaly. We report the case of a 45-year-old man with a displaced bronchus, branching from the left main bronchus and bifurcating into the apicoposterior and anterior segment bronchi of the left upper lobe. The displaced bronchus passed behind the left pulmonary artery. To our knowledge, 12 similar cases of displaced bronchi have been reported to date. Displaced bronchi are difficult to detect prospectively on computed tomography. However, evaluating the accessory fissures may help establish an accurate diagnosis.

Effects of pure and hybrid iterative reconstruction algorithms on high-resolution computed tomography in the evaluation of interstitial lung disease.

OBJECTIVES: To compare image quality characteristics of high-resolution computed tomography (HRCT) in the evaluation of interstitial lung disease using three different reconstruction methods: model-based iterative reconstruction (MBIR), adaptive statistical iterative reconstruction (ASIR), and filtered back projection (FBP). METHODS: Eighty-nine consecutive patients with interstitial lung disease underwent standard-of-care chest CT with 64-row multi-detector CT. HRCT images were reconstructed in 0.625-mm contiguous axial slices using FBP, ASIR, and MBIR. Two radiologists independently assessed the images in a blinded manner for subjective image noise, streak artifacts, and visualization of normal and pathologic structures. Objective image noise was measured in the lung parenchyma. Spatial resolution was assessed by measuring the modulation transfer function (MTF). RESULTS: MBIR offered significantly lower objective image noise (22.24±4.53, P<0.01 among all pairs, Student's t-test) compared with ASIR (39.76±7.41) and FBP (51.91±9.71). MTF (spatial resolution) was increased using MBIR compared with ASIR and FBP. MBIR showed improvements in visualization of normal and pathologic structures over ASIR and FBP, while ASIR was rated quite similarly to FBP. MBIR significantly improved subjective image noise (P<0.01 among all pairs, the sign test), and streak artifacts (P<0.01 each for MBIR vs. the other 2 image data sets). CONCLUSION: MBIR provides high-quality HRCT images for interstitial lung disease by reducing image noise and streak artifacts and improving spatial resolution compared with ASIR and FBP.

Musical preference correlates closely to professional roles and specialties in operating room: A multicenter cross-sectional cohort study with 672 participants.

BACKGROUND: It is unclear whether music preferences and perceptions in the operating room (OR) differ by demographic and professional factors and how an improved understanding of these potential differences can be leveraged to enhance team dynamics and the OR work environment. Currently, there is limited knowledge regarding the impact of music on OR team concentration and communication. METHODS: This study was a multicenter, cross-sectional study of 282 preoperative patients and 390 providers-attending physicians, residents, and nurses in anesthesiology and surgery. Patient and provider responses were measured using a newly developed questionnaire. RESULTS: Patients who highly enjoyed music felt music alleviated stress and enhanced concentration and communication and favored use of music in the OR. The genres favored most by patients were rock music (32%), classical music (28%), and top 40 hits (26%). All providers reported a high frequency of use of music during the operation. Nurses and residents were more likely than attendings to report high enjoyment of music in the OR (P < .02). Surgeons and anesthesiologists had high median scores for enjoyment of music and low median scores for music as distraction. Anesthesiologists preferred classical and jazz/blues at lower volumes compared with surgeons, who favored top 40 music at higher noise pressure levels. Patients and providers perceived music to improve provider concentration and team communication; nurses held the most positive views. CONCLUSION: Musical preferences and perceptions of the effect of music in the OR differ by both professional status and specialty and provide insight into broader team dynamics that could be leveraged potentially to optimize the OR environment.