Publications by authors named "Joshua R Ladner"

3 Publications

  • Page 1 of 1

Are We Speaking the Same Language? Communicating Diagnostic Probability in the Radiology Report.

AJR Am J Roentgenol 2021 03 21;216(3):806-811. Epub 2021 Jan 21.

Department of Radiology, Madigan Army Medical Center, 9040 Jackson Ave, Joint Base Lewis-McChord, Tacoma, WA 98431.

The purpose of this study was to evaluate the level of agreement in diagnostic probability for selected phrases among radiologists and emergency medicine (EM) physicians. A survey was distributed to the radiologists and EM physicians at our academic institution. Respondents selected the degree of diagnostic probability they believe was conveyed by 18 commonly used phrases chosen from studies in the radiology literature. Potential responses for the degree of diagnostic probability were < 10%, ≈ 25%, ≈ 50%, ≈ 75%, and > 90%. Seventy-eight percent (28/36) of EM residents and 56% (14/25) of EM attending physicians (combined fellows and attending physicians) completed the survey; 83% (15/18) of radiology residents and 81% (17/21) of radiology attending physicians completed the survey. There was a high degree of shared understanding for most phrases between the departments except for the phrase "compatible with," which was associated with a higher degree of diagnostic probability by radiologists than by EM physicians ( = .02). Although no term was significantly more specific than any other within the ≈ 50% category or below, "most likely" and "diagnostic of" were significantly more specific than other terms in the ≈ 75% and > 90% categories, respectively. The results of this study show a high degree of shared understanding between radiologists and EM physicians for most of the phrases (17/18) in the survey. The only phrase that showed a significant difference was "compatible with." These results can be used to generate diagnostic probability groups with suggested phrases that can be used when creating radiology reports, thereby improving communication with the emergency department.
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March 2021

A novel treatment for breast pseudoaneurysm in the anticoagulated patient.

Breast J 2020 09 12;26(9):1818-1820. Epub 2020 Apr 12.

Department of Radiology, Madigan Army Medical Center, Tacoma, Washington.

A 74-year-old woman requiring lifetime anticoagulation for antiphospholipid syndrome was noted to develop a pseudoaneurysm (PA) of the breast following core needle biopsy. She was successfully treated via thrombin injection and suffered no complications. In patients requiring anticoagulation, definitive management of PA may be desired. In appropriately selected patients, ultrasound (US)-guided thrombin injection offers superior outcomes to alternative conservative management and obviates the need for surgical intervention.
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September 2020

Tai Chi Improves Brain Metabolism and Muscle Energetics in Older Adults.

J Neuroimaging 2018 07 17;28(4):359-364. Epub 2018 Apr 17.

Center for Clinical Spectroscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Background And Purpose: Tai Chi is a mind-body exercise that has been shown to improve both mental and physical health. As a result, recent literature suggests the use of Tai Chi to treat both physical and psychological disorders. However, the underlying physiological changes have not been characterized. The aim of this pilot study is to assess the changes in brain metabolites and muscle energetics after Tai Chi training in an aging population using a combined brain-muscle magnetic resonance spectroscopy (MRS) examination.

Methods: Six healthy older adults were prospectively recruited and enrolled into a 12-week Tai Chi program. A brain H MRS and a muscle P MRS were scanned before and after the training, and postprocessed to measure N-acetylaspartate to creatine (NAA/Cr) ratios and phosphocreatine (PCr) recovery time. Wilcoxon-signed rank tests were utilized to assess the differences between pre- and post-Tai Chi training.

Results: A significant within-subject increase in both the NAA/Cr ratios (P = .046) and the PCr recovery time (P = .046) was observed between the baseline and the posttraining scans. The median percentage changes were 5.38% and 16.51% for NAA/Cr and PCr recovery time, respectively.

Conclusions: Our pilot study demonstrates significant increase of NAA/Cr ratios in posterior cingulate gyrus and significantly improved PCr recovery time in leg muscles in older adults following short-term Tai Chi training, and thus provides insight into the beneficial mechanisms.
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July 2018