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Acute central nervous system (CNS) trauma in the field is best approached by a systematic and thorough physical and neurologic examination that allows the practitioner to localize the brain or spinal cord injury. The skull and vertebral canal are complex 3-dimensional structures, and orthogonal radiographic views are necessary for an accurate diagnosis. Therapeutics aimed at decreasing pain, inflammation, and edema or increased intracranial pressure in the case of traumatic brain injury should be administered. Survival and return to athleticism can be achieved even in moderate-to-severe traumatic CNS injury with appropriate medical management.Respiratory distress in the horse and foal is an emergency. Managing equine respiratory distress in the field starts with appropriate assessment of the patient to determine whether the breathing obstruction stems from the upper or lower respiratory tract or is nonrespiratory in origin. From a thorough, but efficient, physical examination to point-of-care ultrasound and endoscopy, the veterinarian has many tools in the field to help diagnose the patient.

In patients with embolic stroke of undetermined source (ESUS), paroxysmal atrial fibrillation (AF) is often diagnosed, however, the risk of paroxysmal AF in ESUS has not been well described. Several studies have suggested a linkage between left atrial (LA) functional parameters and risk of AF in stroke patients. The aim of this study was to assess the role of LA functional parameters as predictors of latent paroxysmal AF in ESUS on admission.

Between January 2015 and December 2019, consecutive stroke patients with suspected ESUS at admission were prospectively included in this study. They were under hospital electrocardiographic monitoring for detection of new-onset AF. Various echocardiographic parameters including left atrial strain were assessed for association with new-onset AF.

We gathered 1082 consecutive patients with ischemic stroke. After exclusions, 121 patients with suspected ESUS at admission formed the study cohort. New-onset AF was detected in 46 (38%) patients during hospital electrocardiographic monitoring (median follow-up 18 days). LA pump and reservoir strains were significantly and independently associated with new-onset AF. Receiver operating characteristic analysis for the association with new-onset AF showed that the areas under the curve (AUCs) of clinical parameters plus one of each strain (LA pump strain AUC 0.86±0.04 and LA reservoir strain AUC 0.76±0.05) models were significantly better than plus LA volume index (AUC 0.68±0.04, compared p-values <0.05).

LA strain was significantly associated with new development of AF. Patients with impaired LA function at admission should be carefully monitored to find AF.

LA strain was significantly associated with new development of AF. Patients with impaired LA function at admission should be carefully monitored to find AF.

This article combines a brief narrative review of the Richards Report with an overview of current radiographer advanced and consultant clinical practice (ACCP) to provide suggestions for future ACCP within radiography.

The 'Diagnostics Recovery and Renewal' report by Professor Sir Mike Richards, published in 2020, has identified a need for improvements to be made to diagnostic services. His recommendations include the introduction of Community Diagnostic Hubs (CDHs) that would provide quicker and easier access to diagnostic tests for patients

A narrative review around the concept of Advanced and Consultant Clinical Practice (ACCP) for radiographers demonstrates the capability of the radiographers to expand their role. The article concludes with a vision of how CDHs could potentially provide multiple career pathways for radiographers working at this level of practice.

It is acknowledged that some of these concepts are a combination of visionary and aspirational in outlook rather than being entirely based on current practice. Decursin The intention of this article, and the implications for practice, are to support on-going discussions to enable radiography, as a profession, to seek ways and opportunities to do things differently whilst ensuring that the patient remains at the centre of the services delivered.

It is acknowledged that some of these concepts are a combination of visionary and aspirational in outlook rather than being entirely based on current practice. The intention of this article, and the implications for practice, are to support on-going discussions to enable radiography, as a profession, to seek ways and opportunities to do things differently whilst ensuring that the patient remains at the centre of the services delivered.

Diffusion-weighted imaging (DWI) techniques have drawn attention for their capability of staging hepatic fibrosis. However, the diagnostic performance of DWI for hepatic fibrosis might be affected by hepatic steatosis because hepatic steatosis and fibrosis may have a similar effect on diffusion/perfusion parameters. Therefore, the purpose of our study is to investigate the effect of hepatic steatosis on DWI parameters.

51 patients with MR elastography liver stiffness values below 3.45kPa underwent DWI with multiple b-values and a multi-echo Dixon sequence for fat quantification. Correlation analysis was conducted between fat fraction and DWI parameters, and DWI parameters were compared between steatosis and non-steatosis groups.

Significant negative correlation was observed between fat fraction and apparent diffusion coefficient (ADC) (r=-0.62, p <0.001), pure molecular diffusion (D) (r=-0.62, p <0.001), corrected ADC (D

) (r=-0.36, p=0.01) and a positive correlation with mean kurtosis (K

) (r=0.53, p <0.001). The results of the comparison of DWI parameters were that ADC, D and D

were statistically lower in the steatosis group (p < 0.001, p < 0.001 and p=0.026, respectively) and K

was significantly higher in the steatosis group (p <0.001) compared to the non-steatosis group. However, perfusion-related parameters (D* and f) did not show any statistical significance.

DWI parameters except for perfusion-related parameters (D* and f) are affected by changes in hepatic steatosis. Thus, hepatic steatosis may be considered as a possible confounding factor in DWI-based assessment of liver fibrosis.

DWI parameters except for perfusion-related parameters (D* and f) are affected by changes in hepatic steatosis. Thus, hepatic steatosis may be considered as a possible confounding factor in DWI-based assessment of liver fibrosis.