Lawrence Stein - Academia.edu (original) (raw)

Papers by Lawrence Stein

Research paper thumbnail of Interventional Radiology: From Idea to Device to Patient

McGill Journal of Medicine, 2020

Research paper thumbnail of A clinician's view of mixed health care in Quebec. Interview with Dr. Lawrence A. Stein, Radiologist. Interviewed by Samuel Lapalme-Remis for the MJM

McGill Journal of Medicine, 2008

Research paper thumbnail of Imaging of Small Bowel Obstruction following Gastric Bypass Surgery for Morbid Obesity: A retrospective review

OBJECTIVES This study is a single institution retrospective evaluation of imaging findings of sma... more OBJECTIVES This study is a single institution retrospective evaluation of imaging findings of small bowel obstruction (SBO) after retrocolic antegastric Roux-en-Y gastric bypass surgery for morbid obesity. METHODS The radiological database of 490 patients who underwent gastric bypass surgery for morbid obesity from January 2001-2005 at the Royal Victoria Hospital McGill University Health Center was searched for SBO complications related to the procedure. There were 22 cases of small bowel obstruction related to the procedure. Ten patients had abdominal and pelvic computed tomography (CT) scans, 12 patients had upper gastrointestinal (UGI) and small bowel follow through (SBFT). RESULTS Among 22 cases of SBO, 14 cases were due to anastomotic stenosis or adhesion, 7 due to internal hernia and one to jejuno-jejunal intussusception. Among the 14 patients with SBO related to adhesion and anastomotic narrowing, 11 patients were managed medically and 3 cases managed surgically. CT scans cor...

Research paper thumbnail of Computed tomography colonography: the future of colon cancer screening

1. Can Assoc Radiol J. 2008 Oct;59(4):191-6. Computed tomography colonography: the future of colo... more 1. Can Assoc Radiol J. 2008 Oct;59(4):191-6. Computed tomography colonography: the future of colon cancer screening. Fraser-Hill M, Walsh C, Seppala R, Tao H, Stein L. University of Ottawa, Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada. ...

Research paper thumbnail of Teaching Radiology to Medical Students in Canada; a Virtual, Integrative, Clinical Approach

Canadian Association of Radiologists Journal

Purpose: To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to ... more Purpose: To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to Canadian medical students. Methods: A multidisciplinary team of radiology and other disciplines experts designed an online 5-session course that was delivered to medical students. The topics of each session were clinical cases involving different systems. The target audience was medical students of Canadian schools. Pretests and post-tests were administered before and after each session respectively. An evaluation survey was distributed at the end of the course to gauge students’ perceptions of this experience. Results: An average of 425 medical students attended the live sessions. For each session, 405 students completed both the pre-tests and post-tests. In general, students scored an average of 56% higher on the post-test than on the pre-test. The final course survey was completed by 469 students. The survey results show that more than 98% of students found the course to meet or excee...

Research paper thumbnail of Magnetic Resonance Enterography in the Study of Patients With Crohn's Disease: Which Findings Are More Likely to Change Patient Management?

Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes, 2016

Research paper thumbnail of Improving the Role of CT in Diagnosing Complicated Appendicitis: Are there Occult Signs?

Research paper thumbnail of Duodenal diverticulum with retroperitoneal perforation

Canadian Journal of Surgery Journal Canadien De Chirurgie, Aug 1, 2005

Research paper thumbnail of Poor Resident Research Participation: Identification of Contributory Factors in Canadian Radiology Training Programs

Research paper thumbnail of Who Says GI Radiology Isn't Sexy?

Research paper thumbnail of Detectability of Choledocholithiasis on CT: The Effect of Positive Intraduodenal Enteric Contrast on Portovenous Contrast-enhanced Studies

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association, Jan 8, 2015

To retrospectively assess the accuracy of intravenous (IV) contrast-enhanced multidetector CT (MD... more To retrospectively assess the accuracy of intravenous (IV) contrast-enhanced multidetector CT (MDCT) in choledocholithiasis detectability, in the presence and absence of positive intraduodenal contrast. Over a 3-year period, patients in whom endoscopic retrograde cholangiopancreatography (ERCP) was performed within a week from a portovenous (PV)-enhanced abdominal CT were identified. The final cohort consisted of 48 CT studies in which the entire common bile duct (CBD) length was visualized (19 males, 29 females; mean age, 68 years). We identified two groups according to the absence (n = 31) or presence (n = 17) of positive intraduodenal contrast. CT section thickness ranged from 1.25 to 5 mm. Two radiologists, blinded to clinical information and ERCP results, independently evaluated the CT images. Direct CBD stone visualization was assessed according to previously predefined criteria, correlating with original electronic CT reports and using ERCP findings as the reference standard....

Research paper thumbnail of The Case for CT Colonography: The Future of Colon Cancer Screening. Best Educational Exhibit

Research paper thumbnail of Internal hernia after gastric bypass surgery during middle trimester pregnancy resulting in fetal loss: risk of internal hernia never ends

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Surgery for Obesity and Related Diseases, Volume 5, Issue 3, Pages 378-380, May 2009, Authors:Eva... more Surgery for Obesity and Related Diseases, Volume 5, Issue 3, Pages 378-380, May 2009, Authors:Evangelos Efthimiou, MD, M.Sc., FRCS; LarryStein, MD; Olivier Court, MD; Nicolas Christou, MD, Ph.D. ...

Research paper thumbnail of Computed tomography colonography: the future of colon cancer screening

Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes, 2008

1. Can Assoc Radiol J. 2008 Oct;59(4):191-6. Computed tomography colonography: the future of colo... more 1. Can Assoc Radiol J. 2008 Oct;59(4):191-6. Computed tomography colonography: the future of colon cancer screening. Fraser-Hill M, Walsh C, Seppala R, Tao H, Stein L. University of Ottawa, Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada. ...

Research paper thumbnail of Stent migration causing alimentary limb obstruction necessitating laparotomy and surgical stent extraction

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Research paper thumbnail of A clinician's view of mixed health care in Quebec. Interview with Dr. Lawrence A. Stein, Radiologist. Interviewed by Samuel Lapalme-Remis for the MJM

McGill journal of medicine : MJM : an international forum for the advancement of medical sciences by students, 2008

Research paper thumbnail of Making the best use of radiological resources in Canada

HealthcarePapers, 2005

Diagnostic imaging plays a crucial frontline role in healthcare, providing the information some p... more Diagnostic imaging plays a crucial frontline role in healthcare, providing the information some physicians need to make a diagnosis and determine a course of treatment for their patients. However, wait times for access to diagnostic imaging examinations continue to be long. This is due to a number of factors, including the expanding indications for CT and MRI and growing reliance on imaging studies, Canada's lag in purchasing new equipment, an American influence on the Canadian healthcare system and clinicians' requests for inappropriate examinations. A number of strategies need to be implemented to maximize radiology's efficiency and ensure that services are being used appropriately. The author advocates the use of appropriateness guidelines for referring physicians, delisting tests that are completely inappropriate, implementing the use of radiology information systems, enhancing radiologist efficiency and using physician extenders to perform less complex medical work.

Research paper thumbnail of Soft-tissue case 49. Cecal diverticulitis

Canadian journal of surgery. Journal canadien de chirurgie, 2003

Research paper thumbnail of Canadian Association of Radiologists national advisory on gadolinium administration and nephrogenic systemic fibrosis

Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes, 2008

1. Can Assoc Radiol J. 2008 Dec;59(5):237-40. Canadian Association of Radiologists national advis... more 1. Can Assoc Radiol J. 2008 Dec;59(5):237-40. Canadian Association of Radiologists national advisory on gadolinium administration and nephrogenic systemic fibrosis. Padilla-Thornton A, Zand KR, Barrett B, Stein L, Andrew G, Forster BB. ...

Research paper thumbnail of Pseudoaneurysm of the Superior Mesenteric Artery After Pancreas Transplantation Treated by Endovascular Stenting

Transplantation, 2001

Pseudoaneurysm after pancreas transplantation can have serious consequences, including rupture, h... more Pseudoaneurysm after pancreas transplantation can have serious consequences, including rupture, hemorrhage, and graft loss. We describe a 38-year-old patient who presented with a pseudoaneurysm of the donor superior mesenteric artery 1 month after pancreas transplantation. Selective arteriography was performed and the lesion was repaired with endovascular placement of a 28-mm covered stent. Laparotomy was avoided. The pancreatic graft was continuing to function well 9 months later. As far as we know, this minimally invasive approach was not previously reported. According to published series, pseudoaneurysms often occur secondary to infection and require operative intervention necessitating graft pancreatectomy. Patients can present with serious symptoms including hypotension and shock. Therefore, it is important to detect pseudoaneurysm in a timely manner. Computed tomography and Doppler ultrasound are important diagnostic tools in this regard. We demonstrated the utility of endovascular stenting in the treatment of pseudoaneurysm after pancreas transplantation. When used in a timely manner in well selected patients, endovascular stenting can abrogate the need for operative intervention and its attendant morbidity.

Research paper thumbnail of Interventional Radiology: From Idea to Device to Patient

McGill Journal of Medicine, 2020

Research paper thumbnail of A clinician's view of mixed health care in Quebec. Interview with Dr. Lawrence A. Stein, Radiologist. Interviewed by Samuel Lapalme-Remis for the MJM

McGill Journal of Medicine, 2008

Research paper thumbnail of Imaging of Small Bowel Obstruction following Gastric Bypass Surgery for Morbid Obesity: A retrospective review

OBJECTIVES This study is a single institution retrospective evaluation of imaging findings of sma... more OBJECTIVES This study is a single institution retrospective evaluation of imaging findings of small bowel obstruction (SBO) after retrocolic antegastric Roux-en-Y gastric bypass surgery for morbid obesity. METHODS The radiological database of 490 patients who underwent gastric bypass surgery for morbid obesity from January 2001-2005 at the Royal Victoria Hospital McGill University Health Center was searched for SBO complications related to the procedure. There were 22 cases of small bowel obstruction related to the procedure. Ten patients had abdominal and pelvic computed tomography (CT) scans, 12 patients had upper gastrointestinal (UGI) and small bowel follow through (SBFT). RESULTS Among 22 cases of SBO, 14 cases were due to anastomotic stenosis or adhesion, 7 due to internal hernia and one to jejuno-jejunal intussusception. Among the 14 patients with SBO related to adhesion and anastomotic narrowing, 11 patients were managed medically and 3 cases managed surgically. CT scans cor...

Research paper thumbnail of Computed tomography colonography: the future of colon cancer screening

1. Can Assoc Radiol J. 2008 Oct;59(4):191-6. Computed tomography colonography: the future of colo... more 1. Can Assoc Radiol J. 2008 Oct;59(4):191-6. Computed tomography colonography: the future of colon cancer screening. Fraser-Hill M, Walsh C, Seppala R, Tao H, Stein L. University of Ottawa, Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada. ...

Research paper thumbnail of Teaching Radiology to Medical Students in Canada; a Virtual, Integrative, Clinical Approach

Canadian Association of Radiologists Journal

Purpose: To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to ... more Purpose: To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to Canadian medical students. Methods: A multidisciplinary team of radiology and other disciplines experts designed an online 5-session course that was delivered to medical students. The topics of each session were clinical cases involving different systems. The target audience was medical students of Canadian schools. Pretests and post-tests were administered before and after each session respectively. An evaluation survey was distributed at the end of the course to gauge students’ perceptions of this experience. Results: An average of 425 medical students attended the live sessions. For each session, 405 students completed both the pre-tests and post-tests. In general, students scored an average of 56% higher on the post-test than on the pre-test. The final course survey was completed by 469 students. The survey results show that more than 98% of students found the course to meet or excee...

Research paper thumbnail of Magnetic Resonance Enterography in the Study of Patients With Crohn's Disease: Which Findings Are More Likely to Change Patient Management?

Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes, 2016

Research paper thumbnail of Improving the Role of CT in Diagnosing Complicated Appendicitis: Are there Occult Signs?

Research paper thumbnail of Duodenal diverticulum with retroperitoneal perforation

Canadian Journal of Surgery Journal Canadien De Chirurgie, Aug 1, 2005

Research paper thumbnail of Poor Resident Research Participation: Identification of Contributory Factors in Canadian Radiology Training Programs

Research paper thumbnail of Who Says GI Radiology Isn't Sexy?

Research paper thumbnail of Detectability of Choledocholithiasis on CT: The Effect of Positive Intraduodenal Enteric Contrast on Portovenous Contrast-enhanced Studies

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association, Jan 8, 2015

To retrospectively assess the accuracy of intravenous (IV) contrast-enhanced multidetector CT (MD... more To retrospectively assess the accuracy of intravenous (IV) contrast-enhanced multidetector CT (MDCT) in choledocholithiasis detectability, in the presence and absence of positive intraduodenal contrast. Over a 3-year period, patients in whom endoscopic retrograde cholangiopancreatography (ERCP) was performed within a week from a portovenous (PV)-enhanced abdominal CT were identified. The final cohort consisted of 48 CT studies in which the entire common bile duct (CBD) length was visualized (19 males, 29 females; mean age, 68 years). We identified two groups according to the absence (n = 31) or presence (n = 17) of positive intraduodenal contrast. CT section thickness ranged from 1.25 to 5 mm. Two radiologists, blinded to clinical information and ERCP results, independently evaluated the CT images. Direct CBD stone visualization was assessed according to previously predefined criteria, correlating with original electronic CT reports and using ERCP findings as the reference standard....

Research paper thumbnail of The Case for CT Colonography: The Future of Colon Cancer Screening. Best Educational Exhibit

Research paper thumbnail of Internal hernia after gastric bypass surgery during middle trimester pregnancy resulting in fetal loss: risk of internal hernia never ends

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Surgery for Obesity and Related Diseases, Volume 5, Issue 3, Pages 378-380, May 2009, Authors:Eva... more Surgery for Obesity and Related Diseases, Volume 5, Issue 3, Pages 378-380, May 2009, Authors:Evangelos Efthimiou, MD, M.Sc., FRCS; LarryStein, MD; Olivier Court, MD; Nicolas Christou, MD, Ph.D. ...

Research paper thumbnail of Computed tomography colonography: the future of colon cancer screening

Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes, 2008

1. Can Assoc Radiol J. 2008 Oct;59(4):191-6. Computed tomography colonography: the future of colo... more 1. Can Assoc Radiol J. 2008 Oct;59(4):191-6. Computed tomography colonography: the future of colon cancer screening. Fraser-Hill M, Walsh C, Seppala R, Tao H, Stein L. University of Ottawa, Department of Diagnostic Imaging, The Ottawa Hospital, Ottawa, Ontario, Canada. ...

Research paper thumbnail of Stent migration causing alimentary limb obstruction necessitating laparotomy and surgical stent extraction

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

Research paper thumbnail of A clinician's view of mixed health care in Quebec. Interview with Dr. Lawrence A. Stein, Radiologist. Interviewed by Samuel Lapalme-Remis for the MJM

McGill journal of medicine : MJM : an international forum for the advancement of medical sciences by students, 2008

Research paper thumbnail of Making the best use of radiological resources in Canada

HealthcarePapers, 2005

Diagnostic imaging plays a crucial frontline role in healthcare, providing the information some p... more Diagnostic imaging plays a crucial frontline role in healthcare, providing the information some physicians need to make a diagnosis and determine a course of treatment for their patients. However, wait times for access to diagnostic imaging examinations continue to be long. This is due to a number of factors, including the expanding indications for CT and MRI and growing reliance on imaging studies, Canada's lag in purchasing new equipment, an American influence on the Canadian healthcare system and clinicians' requests for inappropriate examinations. A number of strategies need to be implemented to maximize radiology's efficiency and ensure that services are being used appropriately. The author advocates the use of appropriateness guidelines for referring physicians, delisting tests that are completely inappropriate, implementing the use of radiology information systems, enhancing radiologist efficiency and using physician extenders to perform less complex medical work.

Research paper thumbnail of Soft-tissue case 49. Cecal diverticulitis

Canadian journal of surgery. Journal canadien de chirurgie, 2003

Research paper thumbnail of Canadian Association of Radiologists national advisory on gadolinium administration and nephrogenic systemic fibrosis

Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes, 2008

1. Can Assoc Radiol J. 2008 Dec;59(5):237-40. Canadian Association of Radiologists national advis... more 1. Can Assoc Radiol J. 2008 Dec;59(5):237-40. Canadian Association of Radiologists national advisory on gadolinium administration and nephrogenic systemic fibrosis. Padilla-Thornton A, Zand KR, Barrett B, Stein L, Andrew G, Forster BB. ...

Research paper thumbnail of Pseudoaneurysm of the Superior Mesenteric Artery After Pancreas Transplantation Treated by Endovascular Stenting

Transplantation, 2001

Pseudoaneurysm after pancreas transplantation can have serious consequences, including rupture, h... more Pseudoaneurysm after pancreas transplantation can have serious consequences, including rupture, hemorrhage, and graft loss. We describe a 38-year-old patient who presented with a pseudoaneurysm of the donor superior mesenteric artery 1 month after pancreas transplantation. Selective arteriography was performed and the lesion was repaired with endovascular placement of a 28-mm covered stent. Laparotomy was avoided. The pancreatic graft was continuing to function well 9 months later. As far as we know, this minimally invasive approach was not previously reported. According to published series, pseudoaneurysms often occur secondary to infection and require operative intervention necessitating graft pancreatectomy. Patients can present with serious symptoms including hypotension and shock. Therefore, it is important to detect pseudoaneurysm in a timely manner. Computed tomography and Doppler ultrasound are important diagnostic tools in this regard. We demonstrated the utility of endovascular stenting in the treatment of pseudoaneurysm after pancreas transplantation. When used in a timely manner in well selected patients, endovascular stenting can abrogate the need for operative intervention and its attendant morbidity.