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Mammography and Interventional Breast Procedures
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Mammographic image quality is a combination of contrast, resolution, sharpness, and noise [19]. Image contrast is the difference in optical density between different regions of the mammogram and depends on subject contrast and image receptor contrast. Subject contrast is related to the attenuation of the x-ray beam as it passes through the breast. Image resolution is the ability to record small objects that are close together as separate objects. Image sharpness is the distinctness of the boundary or edges of a structure. Radiographic noise or mottle includes quantum mottle, screen mottle, and film grain. The major cause of this radiographic mottle is quantum mottle, which is caused by the statistical fluctuation in the number of x-ray photons absorbed at individual locations in the intensifying screen. The fewer x-ray photons that are used to make the image, the greater the amount of quantum mottle that results.
Factors affecting image quality
Published in Damian Tolan, Rachel Hyland, Christopher Taylor, Arnold Cowen, Get Through, 2020
Damian Tolan, Rachel Hyland, Christopher Taylor, Arnold Cowen
False – because of quality control in intensifying screen production, structure mottle makes a negligible contribution to total noise relative to the quantum mottle from the high speed of the screen.False – this has no effect on mottle, but will help to reduce the necessary exposure and therefore the patient dose.True.False – with geometric magnification the level of quantum noise remains constant while the size of the image signal increases. This leads to an improvement in the signal to noise ratio. When the image is then reduced in size by optical demagnification, the level of recorded noise is suppressed in the final image.True – by amplifying the low intensity noise signal in the image.
Periorbital Region and Tear Trough
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Colin M. Morrison, Ruth Tevlin, Steven Liew, Vitaly Zholtikov, Haideh Hirmand, Steven Fagien
Soft tissue ischemia is a recorded complication [45]. Signs of soft tissue ischemia include blanching on injection, pain, mottling, blister formation, bluish discoloration, and, later, pustules and tissue necrosis. Mottling in the area of a vascular distribution larger than the injected area is a clue that vascular ischemia is occurring. The mottled appearance can then change into a bluish discoloration, which may appear like a large bruise. Tissue necrosis or eschar formation appears even later. Once the deep dermal layers are affected, scarring will likely occur.
Neuropathology Evaluation of in Utero Correction of Myelomeningocele and Complications of Late-Onset GBS Infection
Published in Fetal and Pediatric Pathology, 2023
Sarah Edminster, Tai-Wei Wu, Alexander Van Speybroeck, Jason Chu, Denise A. Lapa, Ramen H. Chmait, Linda J. Szymanski
The baby was then transferred to the Children’s Hospital Los Angeles Neonatal Intensive Care Unit in stable condition on day 2 of life for multi-disciplinary care. On evaluation, her back incision was well-healed without any evidence of wound dehiscence or cerebrospinal fluid (CSF) leak. For most of her hospital stay, she was well-appearing with progressive improvement in respiratory status. Serial cranial ultrasounds revealed reductions in her ventricle size. During her second week of life, she was weaned off all respiratory support, began to complete her oral feeding goals, and was preparing to be discharged home. However, on day 11 of life, she became lethargic with frequent apneic and bradycardic events. On physical examination, she was pale and mottled. Respiratory support was escalated rapidly for hypercapnic and hypoxemic respiratory failure. Multiple vasopressor-inotropic agents and blood products were administered for circulatory collapse, severe metabolic acidosis, and disseminated intravascular coagulation. Despite aggressive medical intervention, she died after cardiopulmonary arrest on day 12 of life. The blood culture drawn on the day of deterioration subsequently grew GBS. Review of the placental pathology showed evidence of maternal and fetal inflammatory response.
The clinical neglect of vital signs’ assessment: an emerging patient safety issue?
Published in Contemporary Nurse, 2022
Malcolm Elliott, Ruth Endacott
He returned 12 h later and was told to come back in 2 weeks if the pain did not improve; again his vital signs were not assessed during this presentation. The next morning, he was unable to walk and his pain was excruciating. He was therefore driven to the hospital by his father. This time his vital signs were assessed, approximately 33 h after his first presentation (Milligan, 2019). At that point, the patient was deteriorating. He was delirious, clammy and mottled so a rapid medical response call was made. At this point it was recognised the patient had an infected toenail and was in septic shock. Realising he was critically unwell, staff arranged to transfer him to a tertiary referral hospital in a major city hospital; this took 13 h. Shortly after arriving at the referral hospital, the patient went into cardiac arrest and died (Milligan, 2019).
Accelerated shelf life modeling of appearance change in drug products using ASAPprime ®
Published in Pharmaceutical Development and Technology, 2022
Kristina Flavier, James McLellan, Teslin Botoy, Kenneth C. Waterman
The indigo carmine tablets experienced significant color loss at high temperature and RH conditions, shown in Figure S1 of the Supplemental Material. No adjustment to tablet pH was made during the formulation or stressing process, and color change is due to degradation of the indigo carmine dye. Tablets exhibited a loss of blueness, indicated by an increase in the b* value from blue towards yellow. L* increased with color loss, corresponding to a brightening of the tablets. The a* parameter moved in the positive direction towards a neutral color on the red-green spectrum. As color change was observed over all three parameters, total color change, ΔE*, was used in the modeling. A specification limit of ΔE* of 10, corresponding to an obvious visual difference, was defined as unacceptable color change (Figure 1(A)). Although the control tablets were slightly mottled, speckling of the tablets became more apparent as indigo carmine degradation proceeded. Mottled fading is more visually distinctive from even color change and plays a role in setting the specification. Since the colorimeter measures average color over a surface based on an aperture size, inhomogeneous color change is factored into the quantitation.