1.Quantifying Bone Marrow Edema Adjacent to the Lumbar Vertebral Endplate on Magnetic Resonance Imaging: A Cross-Sectional Study of Patients with Degenerative Lumbar Disease
Toshio NAKAMAE ; Naosuke KAMEI ; Yoshinori FUJIMOTO ; Kiyotaka YAMADA ; Takayuki TAMURA ; Yuji TSUCHIKAWA ; Taiki MORISAKO ; Takahiro HARADA ; Toshiaki MARUYAMA ; Nobuo ADACHI
Asian Spine Journal 2022;16(2):254-260
Methods:
Patients with degenerative lumbar diseases, whose MRIs detected BME, were enrolled. On a T2-weighted fat-saturated MRI, BME appeared as a high-intensity region adjacent to the vertebral endplate. We calculated the contrast ratios (CRs) of BME and normal bone marrow using the signal intensities of BME, normal bone marrow, and the spinal cord. On computed tomography, we calculated Hounsfield unit (HU) values in the same area as BME, the sclerotic endplate, and normal bone marrow to assess bone density.
Results:
There were 16 men and 14 women, with an average age of 73.5 years. The mean CRs of BME and normal bone marrow were −0.015±0.056 and −0.407±0.023, respectively. BME’s CR was significantly higher than that of normal bone marrow (p<0.01). The HU values in the same area as BME, the sclerotic endplate, and normal bone marrow were 251.9±24.6, 828.3±35.6, and 98.1±9.3, respectively; these values were significantly different from each other (p<0.01).
Conclusions
The CR on MRI is a useful quantitative assessment tool for BME in patients with degenerative lumbar diseases.
2.Delphi Method Consensus-Based Identification of Primary Trauma Care Skills Required for General Surgeons in Japan
Kazuyuki HIROSE ; Soichi MURAKAMI ; Yo KURASHIMA ; Nagato SATO ; Saseem POUDEL ; Kimitaka TANAKA ; Aya MATSUI ; Yoshitsugu NAKANISHI ; Toshimichi ASANO ; Takehiro NOJI ; Yuma EBIHARA ; Toru NAKAMURA ; Takahiro TSUCHIKAWA ; Toshiaki SHICHINOHE ; Kazufumi OKADA ; Isao YOKOTA ; Naoto HASEGAWA ; Satoshi HIRANO
Journal of Acute Care Surgery 2023;13(2):58-65
Purpose:
General surgeons at regional hospitals should have the primary trauma care skills necessary to treat critically ill trauma patients to withstand transfer. This study was conducted to identify a consensus on primary trauma care skills for general surgeons.
Methods:
An initial list of acute care surgical skills was compiled, and revised by six trauma experts (acute care surgeons); 33 skills were nominated for inclusion in the Delphi consensus survey. Participants (councilors of the Japanese Society for Acute Care Surgery) were presented with the list of 33 trauma care skills and were asked (using web-based software) to rate how strongly they agreed or disagreed (using a 5-point Likert scale) with the necessity of each skill for a general surgeon. The reliability of consensus was predefined as Cronbach’s α ≥ 0.8, and trauma care skills were considered as primarily required when rated 4 (agree) or 5 (strongly agree) by ≥ 80% participants.
Results:
There were 117 trauma care specialists contacted to participate in the Delphi consensus survey panel. In the 1st round, 85 specialists participated (response rate: 72.6%). In the 2nd round, 66 specialists participated (response rate: 77.6%). Consensus was achieved after two rounds, reliability using Cronbach’s α was 0.94, and 34 items were identified as primary trauma care skills needed by general surgeons.
Conclusion
A consensus-based list of trauma care skills required by general surgeons was developed. This list can facilitate the development of a new trauma training course which has been optimized for general surgeons.