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A P Toms

Publications and source records attributed to A P Toms.

11 recordsLinked to original sources
PubMed2006

Building an anonymized catalogued radiology museum in PACS: a feasibility study.

The aim of this study was to test the feasibility of a software application that would allow the anonymization and cataloguing of whole DICOM datasets in order to build searchable radiology museums within PACS. The application was developed on a dedicated networked PC, using C# and HL7 coding. Whole DICOM datasets were pushed from PACS to a networked PC on which the application, Museum Builder, was developed. Museum Builder works by replacing the patient specific data (the forename, surname and hospital number) within each header of each DICOM file with terms from anatomical and surgical sieve menus. The date of birth is anonymized to 1 January of the same year. Whole DICOM datasets comprising hundreds of images can be anonymized and catalogued in a single episode. Museum Builder primes PACS with an HL7 script to receive a "new" patient. DICOM datasets are then pushed back to PACS where they are added to the database as "new" cases. The museum cases can then be searched for, on PACS, by any combination of terms that correspond to appropriate anatomical units, surgical sieve headings or radiological specialty. New radiology reports containing clinical histories, radiological descriptions, differential diagnoses and discussion can be added through the report window. Our institution has developed and used this tool to generate a PACS based radiology museum containing not only full DICOM datasets, but also relevant histological and clinical photographs. In conclusion, this technique offers a mechanism for generating anonymized catalogued radiology museums in PACS. Museum Builder represents a working prototype that demonstrates some of the archiving functions that are expected by teaching institutions from PACS.

Cataloging↗
PubMed2005

Regional migratory osteoporosis: a review illustrated by five cases.

Regional migratory osteoporosis is an uncommon self-limiting disease characterized by an arthralgia which migrates between the weight-bearing joints of the lower limb. The radiological features of the disease obtained by conventional radiography, CT, MRI and radionuclide scintigraphy are illustrated by means of five case reports. These range from the most common presentation of sequential, proximal to distal spread in the lower limb to the rare intra-articular form, and disease involving the axial skeleton is also recognized. Clinical and radiographical features often overlap with those of diseases such as transient osteoporosis of the hip and transient bone marrow oedema syndrome, which is reflected in confusing terminology. Histological sampling is usually unnecessary; the radiological features are characteristic and the histological findings are not specific. Regional migratory osteoporosis is associated with systemic osteoporosis. This association is probably under-recognized, and has implications for the pathophysiology of the disease and for treatment.

Adult↗
PubMed2003

Descending urethral ultrasound of the native and reconstructed urethra in patients with hypospadias.

A retrospective study, over a 7 year period, examining the use of descending urethral ultrasound in corrected and uncorrected hypospadias was performed. 15 examinations were performed on 14 patients; 12 patients had undergone previous surgery for hypospadias, ranging from urethral reconstruction to stricture dilatation. Eight strictures, four irregular urethras, two normal post-operative urethras and one urethral valve were demonstrated. All the clinically significant abnormalities (those which impaired the flow of urine) demonstrated by ultrasound were confirmed with subsequent urethroscopy or contrast urethrography. This small series illustrates the application of descending urethral ultrasound in patients with hypospadias who are difficult to examine with more conventional radiographic techniques.

Adolescent↗
PubMed2001

Requests for body computed tomography: increasing workload, increasing indications and increasing age.

Increasing numbers of increasingly elderly patients were being examined in our Body CT department. At the same time, some of our clinical colleagues perceived that their patients might be discriminated against on the basis of their age when allocating CT time. We therefore studied the population trends in our department over a 10-year period. The ages of patients attending the Body CT department were collected from the hospital's computer information system from 1995 to 2000 and from handwritten logbooks for the months of September 1988 and 1998. Comparison was made with population trends within the hospital and local demographic data. There has been an average increase of 11% per annum in the number of examinations performed in the Body CT unit. The average age of patients examined increased from 52.7 years in 1988 to 58.9 years in 1998. The largest increase occurred in the over 75-year population (18% rise per annum). Hospital and local demographic population profiles changed little during the same period. We are performing increasing numbers of body CT examinations on increasingly elderly patients. This is probably due to an increased willingness to investigate and treat elderly patients, rather than changes in the local population. There is no evidence of a general discriminatory policy on the basis of age.

Adolescent↗
PubMed2001

A prospective randomised study comparing enteroclysis with small bowel follow-through examinations in 244 patients.

The purpose of this study was to determine whether small bowel enema or barium follow-through is the most appropriate examination for the routine investigation of patients without documented small bowel disease referred from outpatient sources in our hospital. Two hundred and forty-four patients were prospectively randomised to either small bowel enema (SBE) or barium follow-through (FT). Radiation doses and room times were recorded for the first 95 patients and abnormal results were documented for all. One hundred and twelve FTs and 75 SBEs were performed. The incidence of abnormal results was low overall and comparable in the two groups. There were significantly more abnormalities in the FT group which required further investigations for confirmation. Of those assigned to SBE, 19% were converted to FT due to patient refusal and technical failure. Radiation doses were similar in the two groups, but the time spent occupying the fluoroscopy room was significantly shorter for FT. In our department FT is as effective as SBE in detecting small bowel abnormalities de novo. The radiation dose is similar, but more FTs can be performed per list. Follow-through is also less invasive than SBE and therefore we use this technique as the first line of investigation in this group of patients.

Adolescent↗
PubMed2001

The fog clears.

Explore the source record for details and available documents.

Adult↗
PubMed1999

Illustrated review of new imaging techniques in the diagnosis of abdominal wall hernias.

BACKGROUND: The assessment of abdominal wall hernias has long been a clinical skill that only occasionally required the supplementary radiological assistance of herniography. However, with the advent of cross-sectional imaging, a new range of diagnostic tools is now available to help the clinician in difficult cases. METHODS: This review explores the ability of computed tomography and magnetic resonance imaging to demonstrate many of the hernias encountered in the anterior abdominal wall. Also discussed is the role of imaging techniques in the management of a variety of hernias. RESULTS AND CONCLUSION: Cross-sectional imaging techniques are being employed with increasing frequency for the assessment of hernias. Although the anatomical detail can usually be delineated clearly, the accuracy of the various methods and their place in the clinical management of hernias has yet to be fully determined.

Cross-Sectional Studies↗
PubMed1996

Assessment of peritonism in appendicitis.

The aim of this study was to evaluate the accuracy of different methods of demonstrating right iliac fossa peritonism in appendicitis. The methods used were cat's eye symptom (pain on going over a bump in the road), cough sign, right iliac fossa tenderness, percussion tenderness, rebound tenderness and guarding. A series of 100 consecutive patients with a median age of 25 years (range 4-81 years), presenting with right iliac fossa pain were studied prospectively; the male:female ratio was 39:61. In all, 58 patients underwent operation, 44 had appendicitis confirmed on histology. Fourteen patients had a normal appendix removed; 11 were women aged between 16 and 45 years. Cat's eye symptom and cough sign were sensitive indicators of appendicitis (sensitivity 0.80 and 0.82, respectively), but were not specific (specificity 0.52 and 0.50, respectively) and therefore inaccurate (accuracy 64%). Percussion tenderness was less sensitive (sensitivity 0.57) but more specific (specificity 0.86). Rebound tenderness proved to be sensitive (sensitivity 0.82), specific (specificity 0.89) and accurate (accuracy 86%). Thus, rebound tenderness had a positive predictive value of 86% compared with 56% and 57% for cough sign and cat's eye symptom, respectively. In the difficult diagnostic group of young women, the positive predictive value of rebound tenderness was 88% compared with 58% and 56% for cat's eye symptom and cough sign. Appendicitis remains a difficult diagnosis, particularly in young women. Rebound tenderness still has an important role to play in clinical assessment.

Abdominal Pain↗
PubMed1989

Class III malocclusion: a cephalometric study of Saudi Arabians.

The records of 500 consecutive Saudi Arabian patients referred for orthodontic treatment were examined clinically and cephalometrically for Class III malocclusion. A control group was drawn at random from the same sample. The incidence of Class III was 9.4 per cent, with mandibular prognathism being the commonest presentation of the malocclusion. The upper and lower incisors exhibited a marked degree of dentoalveolar compensation, on dental bases having mean values of SNA--78.77 degrees and SNB--81.17 degrees. The maxillary length was reduced, as were the saddle and maxillary-mandibular plane angles. The gonial angle (ArGoMe), anterior and posterior facial heights, and mandibular lengths (ArGo, ArPo) were all significantly larger than the control group. The cephalometric values of the control group showed the increased tendency to bimaxillary protrusion in the Saudi Arabian sample.

Adolescent↗