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  • Twice the Power in New MRI

    Abstract Full Text
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    JAMA. 2017; 318(19):1858-1858. doi: 10.1001/jama.2017.17120
  • MRI for Neonates

    Abstract Full Text
    JAMA. 2017; 318(9):790-790. doi: 10.1001/jama.2017.10934
  • JAMA August 8, 2017

    Figure 2: Distribution of Volume of Infarcted Brain Tissue by Randomization Group Observed on the Day 7 Diffusion-Weighted MRI Scan

    Panels A and B depict the cumulative distribution of observed infarct volume up to the 90th percentile for each treatment group compared with the control group. The y-axis gives the percentage of patients with an observed total infarct volume less than or equal to that of the corresponding infarct volume on the x-axis. IQR indicates interquartile range; MRI, magnetic resonance imaging.
  • JAMA June 27, 2017

    Figure: Sound Health: An NIH-Kennedy Center Initiative to Explore Music and the Mind

    Functional magnetic resonance imaging (MRI) scan of coauthor Renée Fleming imagining herself singing an excerpt of “River Songs” (a medley by Dave Grusin). The colors indicate an increase in fMRI signal, commonly interpreted as increased brain activity. Areas where a statistically significant increase in activity was not observed are shown in gray. Darker gray regions indicate indentations in the cortex. Like speaking and overt singing, imagined singing activates motor regions and auditory-motor integration regions, but this silent rehearsal did not excite primary auditory regions. Imagined singing also activates regions in the inferior frontal cortex, believed to play a role in musical syntax and motor preparation, and the amygdala, commonly implicated in studies of emotion and arousal. These results from one individual are similar to those seen in larger studies of singers.
  • Avoiding Unnecessary Prostate Biopsies With MRI

    Abstract Full Text
    JAMA. 2017; 317(12):1206-1206. doi: 10.1001/jama.2017.2745
  • JAMA February 7, 2017

    Figure 1: Anatomy Surrounding the Pituitary Gland and Magnetic Resonance Imaging of Pituitary Adenomas

    CN indicates cranial nerve. Yellow arrows indicate location of adenomas.
  • JAMA September 6, 2016

    Figure 2: Proportion of All First-Trimester Magnetic Resonance Imaging by Completed Gestational Week at Exposure

    There were 1720 women who underwent magnetic resonance imaging during their first trimester of pregnancy. Error bars indicate 95% confidence intervals.
  • JAMA September 6, 2016

    Figure 3: Incidence Rate of a Congenital Anomaly in Relation to Magnetic Resonance Imaging Exposure Within Each Completed Gestational Week

    Data are presented for magnetic resonance imaging (MRI) completed within the first trimester of pregnancy. A total of 4884 completed person-years were included in this analysis. Error bars indicate 95% confidence intervals.
  • Association Between MRI Exposure During Pregnancy and Fetal and Childhood Outcomes

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    JAMA. 2016; 316(9):952-961. doi: 10.1001/jama.2016.12126

    This study analyzed Ontario, Canada, databases to assess the effect of MRI during the first trimester or MRI with gadolinium anytime during pregnancy on offspring until they were 4 years old.

  • JAMA August 9, 2016

    Figure 1: Treatment Flow of Patients in the CLEAN-TAVI Trial

    aReasons ineligible for transcatheter aortic valve implantation (TAVI): not suitable for transfemoral access (heavy calcification with resulting stenosis, high tortuosity); coronary origin less than 8 mm from the aortic annulus; or aortic annulus size too small or large.bSee 4.2.4 Preinterventional Procedures in Supplement 1.cPatient indicated study consent would be withdrawn if TAVI was without filter protection. Therefore, a cerebral protection device was used, but the patient remained in the control group per the intention-to-treat principle.dStill underwent clinical follow-up.eIndicates clinical instability and inability to leave the intensive care unit (ICU) for magnetic resonance imaging (MRI) assessment.fOf those who received the 2-day MRI in the filter group, 3 of 49 MRIs (6.1%) and in the control group, 2 of 45 MRIs (4.4%) were performed using the 1.5T scanner (absolute difference, 1.7%). Of those who received the 7-day MRI in the filter group, 4 of 45 MRIs (8.8%) and in the control group, 1 of 43 MRIs (2.3%) were performed using the 1.5T scanner (absolute difference, 6.5%).The 1.5T scanner was used because some patients were intermittently pacer dependent with temporary leads in place (not approved for use with 3T MRI).
  • Association Between Gadolinium Contrast Exposure and the Risk of Parkinsonism

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    JAMA. 2016; 316(1):96-98. doi: 10.1001/jama.2016.8096

    This cohort study uses Ontario administrative data to assess the association between gadolinium exposure during magnetic resonance imaging and parkinsonism.

  • JAMA June 14, 2016

    Figure 1: Clinical Disease Characteristics and Suggested Algorithm for Diagnostic Evaluation of Patients With Symptoms of Polymyalgia Rheumatica or Suspected Giant Cell Arteritis

    The approach incorporates the currently most useful investigations for ascertaining the diagnosis of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) and exclusion of relevant mimicking conditions. This algorithm is based upon assessment of the available literature. It has not been formally tested in a randomized clinical trial. 18F-FDG-PET indicates fluorodeoxyglucose F 18 positron emission tomography and MRI indicates magnetic resonance imaging.aFrom 40% to 60% of patients diagnosed with GCA also have PMR, and 16% to 21% of PMR patients have GCA.bPMR and GCA (including disease overlap) is possible if there are both typical and atypical symptoms and signs, including normal erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP), and/or abnormal findings at initial laboratory investigations that prompt further evaluation.cPMR and GCA (including disease overlap) is unlikely (but not ruled out) since inflammatory markers are elevated in more than 90% of patients in both diseases.dPMR and GCA (including disease overlap) is likely if there are typical symptoms and signs including raised ESR, CRP, or both and no abnormal findings that prompt further evaluation.
  • JAMA May 3, 2016

    Figure 4: Proposed Strategy for the Evaluation and Management of a Pancreatic Cyst

    BD-IPMN indicates branch duct intraductal papillary mucinous neoplasm; CEA, carcinoembryonic antigen; CT, computed tomography; EUS-FNA, endoscopic ultrasound–guided fine needle aspiration; IPMN, intraductal papillary mucinous neoplasm; MCN, mucinous cystic neoplasm; MD-IPMN, main duct intraductal papillary mucinous neoplasm; MPD, main pancreatic duct; MRI, magnetic resonance imaging; SCA, serous cystadenoma.
  • JAMA March 15, 2016

    Figure 1: Flow of Participants in the Study of Effect of Inhaled Xenon on Cerebral White Matter Damage in Comatose Patients Who Experienced Out-of-Hospital Cardiac Arrest

    MRI indicates magnetic resonance imaging.aPatient was first transmitted to the wrong hospital; an initiation of possible xenon treatment was not possible within 4 hours.
  • Effect of Vitamin D Supplementation on Tibial Cartilage Volume and Knee Pain Among Patients With Symptomatic Knee Osteoarthritis: A Randomized Clinical Trial

    Abstract Full Text
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    JAMA. 2016; 315(10):1005-1013. doi: 10.1001/jama.2016.1961

    This randomized trial evaluates the use of vitamin D supplementation vs placebo in treating knee pain and preventing tibial cartilage loss among patients with symptomatic knee osteoarthritis.

  • JAMA March 8, 2016

    Figure 1: Flowchart of Participants in the VIDEO Study

    MRI indicates magnetic resonance imaging.
  • Coaching Does Not Prevent Low-Value Diagnostic Testing

    Abstract Full Text
    JAMA. 2016; 315(4):337-337. doi: 10.1001/jama.2015.18979
  • JAMA December 22, 2015

    Figure 1: Sagittal and Axial Magnetic Resonance Imaging (MRI) of the Spinal Cord From Representative Patients in This Case Series

    Spinal cord MRI typically revealed longitudinally extensive (>3 vertebral bodies) T2 hyperintense lesions affecting spinal gray matter with relative sparing of adjacent white matter (A-J), although various accompanying radiological features were also observed. In some patients, lesions traversed the entire cord with a stable, symmetric appearance (arrowhead in A), whereas other patients demonstrated patchy, asymmetric lesions affecting discrete segments of the cord (arrowheads in B and C). In other patients, subtler lesions (white arrowhead in D) were observed adjacent to more severely affected segments manifesting cord edema (black arrowhead in D). Brainstem lesions were occasionally observed (white arrowheads in C and D) and often correlated with cranial nerve weakness. Although certain lesions appeared to affect dorsal as well as ventral gray matter, the lesions were typically more prominent within the ventral gray matter (G and J), consistent with the location of the spinal motor neurons. Axial sequences revealed spinal lesions that included a “snake eyes” or “owl eyes” appearance highlighting the bilateral ventral horns (F and J), increased T2 signal highlighting the majority of the spinal gray matter (G), unilateral lesions of the ventral horns (H and I), lesions affecting both spinal gray matter and adjacent white matter (I). A distended bladder was observed (white arrowhead in part E) in association with edematous lesions of the conus (black arrowhead in E) in a child with lower limb paralysis. Brainstem and cord lesions are consistent with descriptions of similar cases reported in Colorado in 2014. The black arrowheads in the sagittal images (A-E) demarcate the approximate anatomic level of the associated axial images (F-J, respectively).
  • Distal Symmetric Polyneuropathy: A Review

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    JAMA. 2015; 314(20):2172-2181. doi: 10.1001/jama.2015.13611

    This narrative review summarizes current thinking about the diagnosis and treatment of distal symmetric polyneuropathy.