To determine the diagnostic bias between clinical and forensic radiology in cases of nonfatal hanging and determine and describe typical underreported imaging findings. In a retrospective, single-center study, all patients admitted for attempted suicide with near-hanging or fatal hanging between January 2008 and December 2020 who received CT or MRI of head and neck were reviewed and missed findings in the original report were documented. A binary regression with disagreement as dependent variable was fitted for the imaging modality, fatality, age, and sex. A total of 123 hanging incidents were retrospectively analyzed. The vast majority (n = 108; 87.8%) had attempted suicide with a nonfatal outcome. Fatal outcome occurred in 15 (12.0%). The extra- and intracranial injuries documented on CT and MRI scans were laryngeal (n = 8; 6.5%), soft tissue (n = 42; 34.1%), and vascular injuries (n = 1; 0.8%). Intracranial pathology was evident on 18 (14.6%) scans. Disagreement occurred in 36 (29.3%) cases and represented 52 (69.2%) of all cases with a radiological finding. Disagreement was strongly associated with fatality (OR: 2.7-44.9.4, p = 0.0012). In most cases, nonfatal hangings cause no or only minor injuries. Fatal cases are associated with a greater probability of missed minor imaging findings. This suggests that findings deemed clinically irrelevant are probably not reported in such severe emergency cases. This association indicates that minor abnormalities are underreported when major pathologies are evident on imaging in victims of strangulation.

An effective healthcare system should embrace practices that enhance overall quality and productivity. Training primary care physicians in Point-of-Care Ultrasound (POCUS) has become part of the processes that improve the quality of patient care and serve to guide the diagnostic impression quickly and effectively. With the purpose of highlighting the applications and challenges of POCUS use in US primary health care, we conducted a narrative review based on PubMed-indexed and Cochrane Library English text publications searched in May-July 2022 using a combination of key terms including point of care ultrasound, primary care, and US healthcare. Many studies have shown that POCUS has a positive impact on fostering medical attention and reducing morbidity, mortality, and healthcare costs. Besides assisting in procedures, POCUS has a head-to-toe application in evaluating inflammatory and infectious conditions, acute abdomen, cardiopulmonary function, musculoskeletal and vascular pathologies. However, its uniform implementation is limited across the US healthcare system due to multitudes of barriers such as lack of training, resource scarcity, and low reimbursement. Training primary care physicians in general and emergency care providers, in particular, is key to scaleup POCUS use. Large size studies are paramount to further explore the effectiveness of POCUS and identify key challenges to its implementation.

BACKGROUND: The Royal Australian and New Zealand College of Radiologists (RANZCR) led the medical community in Australia and New Zealand in considering the impact of machine learning and artificial intelligence (AI) in health care. RANZCR identified that medical leadership was largely absent from these discussions, with a notable absence of activity from governments in the Australasian region up to 2019. The clinical radiology and radiation oncology sectors were considered ripe for the adoption of AI, and this raised a range of concerns about how to ensure the ethical application of AI and to guide its safe and appropriate use in our two specialties.
METHODS: RANZCR\'s Artificial Intelligence Committee undertook a landscape review in 2019 anddetermined that AI within clinical radiology and radiation oncology had the potential to grow rapidly and significantly impact the professions. In order to address this, RANZCR drafted ethical principles on the use of AI and standards to guide deployment and engaged in extensive stakeholder consultation to ensure a range of perspectives were received and considered.
RESULTS: RANZCR published two key bodies of work: The Ethical Principles of Artificial Intelligence in Medicine, and the Standards of Practice for Artificial Intelligence in Clinical Radiology.
CONCLUSIONS: RANZCR\'s publications in this area have established a solid foundation to prepare for the application of AI, however more work is needed. We will continue to assess the evolution of AI and ML within our professions, strive to guide the upskilling of clinical radiologists and radiation oncologists, advocate for appropriate regulation and produce guidance to ensure that patient care is delivered safely.

BACKGROUND: Correlation of the manifestations of tuberculosis and the degree of immunosuppression in patients with HIV.
BACKGROUND: The advent of HIV has contributed to the increase in the number of people with tuberculosis. The clinical and paraclinical of TB/HIV co-infected are polymorphic and function of immune status.
OBJECTIVE: To determines the clinical and paraclinical characteristics of TB related to different levels of CD4 lymphocytes.
METHODS: A retrospective case series based on analysis of 450 patients with both TB/HIV co-infections. It focused on the records of patients with pulmonary smear-positive (TPM +) with a positive HIV status. The effect of immunosuppression was analyzed in groups based on the CD4 count (<200/mm(3), of 200-350/mm(3) and>350/mm(3)), in a chronological fashion from April to September 2010 until there were 150 patients in each CD4 group.
RESULTS: Among the 450 patients, 71.1% were between 25 and 45years old. The clinical signs were more significant as the level of CD4 fell. The clinical signs were predominantly fever (93%) and weight loss (62.7%). Pulmonary cavitation (59.3%), infiltrates (38.7%) and the location of the lesions at the lung apex (72%) were more common in the third group patients. By contrast, extra pulmonary lesions (mediastinal lymphadenopathy, pleurisy) and normal x-ray (9.3%) were more frequent in patients of the first group. The scarcity of cavitations (22.3% compared to 59.3% CD4>350) and the increase in associated lesions became more marked if patients were immunocompromised. Hematologic, hepatic, renal disorders were more frequent and severe in the most immunocompromised patient group.
CONCLUSIONS: HIV-associated tuberculosis has an atypical clinical, radiological, biological presentation and is more severe when there is significant immunosuppression.