Faculty Bibliography

Early detection of lung nodules is an important clinical indication for obtaining routine CT studies of the thorax. To date, research has focused on the sensitivity of computer-aided diagnosis (CAD) compared with expert chest radiologists typically using data obtained from single detector CT scanners. The present study focuses on the use of CAD as a second reader supplementing four nonexpert "community level" radiologists using state-of-the-art multidetector high resolution data sets. Evaluations of 18 cases with a total of 87 nodules (average 4.8 per case) were subsequently validated by a panel of two expert dedicated chest radiologists. Only 21% of nodules were identified by all four readers; 17% were identified only by CAD. The mean sensitivity of readers before CAD was 49% while following CAD this improved to 72% (p<0.001). When analyzed by individual lobes, the percentage of these in which nodules could be identified increased from 36% prior to CAD to 44% following CAD (p<0.001). These data support the use of CAD as a second reader specifically for nonexpert radiologists in general clinical practice. (C) 2004 CARS and Elsevier B.V. All rights reserved

This is a case of a newborn with a rare testicular tumor-a juvenile granulosal cell tumor. This is a tumor of stromal origin, which is similar histologically to granulosal cell tumors of the ovaries. The authors present the imaging characteristics and differential diagnoses in this patient.

BACKGROUND: Compared with 5 days of dosing, a 3 day dosing regimen of azithromycin for treatment of acute otitis media (AOM) may improve compliance, will simplify therapy for the caregiver and, by giving the same total dose as the 5 day regimen, provide more drug when the bacterial burden is highest. METHODS: Children of 6 months-12 years were enrolled if they had had symptoms and signs of AOM for <4 weeks and tympanic membrane effusion by acoustic reflectometry. Eligible children were randomized to azithromycin 10 mg/kg/day x 3 days or co-amoxiclav 45 mg/kg/day x 10 days. The primary endpoint was clinical response at day 28. RESULTS: One hundred and eighty-eight children (mean age 3.5 years) were randomized to azithromycin and 185 to co-amoxiclav. At day 10, the clinical success rate was 153/185 (83%) in children treated with azithromycin and 159/181 (88%) in children treated with co-amoxiclav. At day 28, 134/182 (74%) of the children were cured on azithromycin compared with 124/180 (69%) on co-amoxiclav. Also at day 28, signs of AOM, such as abnormal reflectometry (45% versus 59%; P = 0.017), bulging of the eardrum (10% versus 16%; P = 0.059) and loss of tympanic membrane landmarks (11% versus 22%; P = 0.010) were seen less frequently in azithromycin- than co-amoxiclav-treated children, respectively. Adverse events related to therapy were seen in 11% of azithromycin patients compared with 20% on co-amoxiclav (P = 0.014). CONCLUSIONS: Azithromycin given over 3 days is as effective as co-amoxiclav for treatment of AOM, may result in more complete resolution of tympanic membrane disease, and is better tolerated.