During a median follow up of 6 5 years until March 2007 (11,316 p

During a median follow up of 6.5 years until March 2007 (11,316 person-years at risk), selleck chemicals llc a total of 163 new CHID events (27 fatal and 136 nonfatal) occurred. The prevalence of MetS in subjects with TG/HDL-C >= 6.9 (top quartile) reached 63.6% versus 3.0% in those with TG/HDL-C < 2.8 (low quartite). According to a stepwise Cox proportional hazard model, including TG and TG/HDL-C quartiles, with TC and other risk factors, men in the top quartile of

TG/HDL-C relative to the first quartite had a significant hazard ratio (HR) of 1.75 (95% CI, 1.02-3.00), white TG did not remain in the model.

Conclusion: The evaluation of TG/HDL-C ratio should be considered for CHD risk prediction in our mate population learn more with a high prevalence of MetS. (c) 2008 Elsevier B.V. All rights reserved.”
“Study Design. Case series.

Objective. To describe 4 cases of unstable subaxial cervical spine injury not demonstrated with initial radiograph, computed tomography

(CT), and magnetic resonance (MR) imaging.

Summary of Background Data. When evaluating the cervical spine for ligamentous or osseous injuries in the blunt trauma patient population, negative predictive value measurements of 100% for CT and MR imaging have been published. Unstable subaxial cervical spine injury has rarely been reported in the spine literature in conjunction with initial radiograph, CT, and MR imaging demonstrating no osseous or ligamentous injury. Historically, reports of subacute cervical spine

instability following trauma exist and were presented before the availability of MR and multidetector CT imaging.

Methods and Results. We report 4 examples of unstable subaxial cervical spine injury each with initial imaging interpreted as negative. All 4 cases presented selleck chemical at a level-one tertiary care facility. Follow-up radiographs demonstrated unstable cervical spine injuries requiring surgical stabilization.

Conclusion. Notwithstanding high sensitivities, specificities, and negative predictive values for cervical spine imaging and “”clearance”" mechanisms, 4 cases that illustrate the potential for undetected unstable cervical spine injuries are presented. Tremendous advancements in medical imaging have been made. However, radiograph, CT, and MR imaging may still fail to accurately translate the anatomic and dynamic complexity of the cervical spine into digital images that accurately guide clinical practice. A full understanding of and keen appreciation for the fact that no imaging technique, classification method, or clearance protocol can produce 100% sensitivity at all times is essential. These case reports cumulatively demonstrate a 0.04% to 0.2% incidence of undetected cervical injury requiring surgical stabilization.

Comments are closed.