Ultrasound in Renal Pyogenic Infection

1988 ◽  
Vol 29 (6) ◽  
pp. 675-678 ◽  
Author(s):  
T. Vehmas ◽  
M. Päivänsalo ◽  
M. Taavitsainen ◽  
I. Suramo
Keyword(s):  
Renal Abscess ◽  
Ultrasound Guided ◽  
Percutaneous Aspiration ◽  
Drainage Procedure ◽  
Pyogenic Infection ◽  
The Mean ◽  
The Difference ◽  
Difficult Cases ◽  
Collecting System ◽  
Overall Mortality

A series of 34 patients with renal or perirenal pyogenic infection (18 with pyonephrosis, 10 with renal abscess and 6 with perirenal abscess) is presented to evaluate diagnosis with ultrasound and treatment with percutaneous ultrasound guided aspiration/drainage. Specific findings, defined as sediment echoes or dispersed internal echoes in a hydronephrotic renal collecting system, were noted in 39 per cent of pyonephrosis cases. Abscesses were mainly round or oval hypoechoic lesions measuring from 2 to 15 cm in diameter. Two abscesses were multilocular and one showed a septum. The appearance suggested tumor in 25 per cent. Because of this non-specificity of ultrasound we recommend diagnostic aspirations and further radiologic and other examinations in difficult cases. Four patients were treated by conservative means only, 13 with percutaneous aspiration or drainage, 9 with a combined drainage procedure and surgery, and 8 surgically. The length of the mean hospital stay was shortest in the group with the percutaneous drainage procedure (PDP) although the difference was not statistically significant. PDP was not effective in 12 per cent and surgery was used in these two cases to ensure cure. Complications occurred more often in the PDP group than in the surgery group but the most serious complication was a post-operative one. The different modes of treatment are discussed. The overall mortality was 5.9 per cent.

scholarly journals Can ultrasound guidance reduce the risk of pneumothorax following thoracentesis?

2014 ◽  
Vol 40 (1) ◽  
pp. 6-12 ◽  
Author(s):  
Alessandro Perazzo ◽  
Piergiorgio Gatto ◽  
Cornelius Barlascini ◽  
Maura Ferrari-Bravo ◽  
Antonello Nicolini
Keyword(s):  
Ultrasound Guidance ◽  
Volume Of Fluid ◽  
Ultrasound Guided ◽  
Clinical Trial Registry ◽  
Fluid Removal ◽  
Standardized Protocol ◽  
Iatrogenic Complications ◽  
Support Team ◽  
The Mean ◽  
The Difference

OBJECTIVE: Thoracentesis is one of the bedside procedures most commonly associated with iatrogenic complications, particularly pneumothorax. Various risk factors for complications associated with thoracentesis have recently been identified, including an inexperienced operator; an inadequate or inexperienced support team; the lack of a standardized protocol; and the lack of ultrasound guidance. We sought to determine whether ultrasound-guided thoracentesis can reduce the risk of pneumothorax and improve outcomes (fewer procedures without fluid removal and greater volumes of fluid removed during the procedures). In our comparison of thoracentesis with and without ultrasound guidance, all procedures were performed by a team of expert pulmonologists, using the same standardized protocol in both conditions. METHODS: A total of 160 participants were randomly allocated to undergo thoracentesis with or without ultrasound guidance (n = 80 per group). The primary outcome was pneumothorax following thoracentesis. Secondary outcomes included the number of procedures without fluid removal and the volume of fluid drained during the procedure. RESULTS: Pneumothorax occurred in 1 of the 80 patients who underwent ultrasound-guided thoracentesis and in 10 of the 80 patients who underwent thoracentesis without ultrasound guidance, the difference being statistically significant (p = 0.009). Fluid was removed in 79 of the 80 procedures performed with ultrasound guidance and in 72 of the 80 procedures performed without it. The mean volume of fluid drained was larger during the former than during the latter (960 ± 500 mL vs. 770 ± 480 mL), the difference being statistically significant (p = 0.03). CONCLUSIONS: Ultrasound guidance increases the yield of thoracentesis and reduces the risk of post-procedure pneumothorax. (Chinese Clinical Trial Registry identifier: ChiCTR-TRC-12002174 [http://www.chictr.org/en/])

scholarly journals A COMPARATIVE STUDY OF CAUDAL BLOCK AND ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE BLOCK WITH LEVOBUPIVACAINE AND DEXAMETHASONE AS ADDITIVE IN EXTRAPERITONEAL LOWER ABDOMINAL SURGERIES IN PEDIATRICS

2021 ◽  
pp. 173-176
Author(s):  
SANDHYA GHODKE ◽  
MADHAVI N ◽  
HIREMATH RN
Keyword(s):  
General Anesthesia ◽  
Transversus Abdominis ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Caudal Block ◽  
Ultrasound Guided ◽  
Operative Complications ◽  
The Mean ◽  
The Difference ◽  
Post Operative Complications

Objective: The objective of the study was to evaluate the efficacy of ultrasound-guided transversus abdominis plane (TAP) block versus caudal block for post-operative analgesia with levobupivacaine and dexamethasone as additive in extraperitoneal lower abdominal surgeries in pediatrics as there is no available literature showing the same. Methods: This is a randomized control study carried out between two groups among 50 children (1–8 years of age), both sexes, posted for elective extraperitoneal lower abdominal surgeries after taking informed consent from parents. Fifty children were randomly allocated into two groups, 25 in each group. Caudal epidural (CE) group received general anesthesia and caudal block with 1 ml/kg of 0.2% levobupivacaine and 0.1 mg/kg dexamethasone. TAP group received general anesthesia and ultrasound-guided TAP block with 0.5 ml/kg of 0.2% levobupivacaine and 0.1 mg/kg dexamethasone. Data were collected by means of pre-designed format with pre-/post-operative assessment with standardized scores. Results: The mean age of the patients was 4.84 (SD=2.29). Mean face, legs, activity, cry, and consolability score was low and non-significant before shifting the patient (<2 h post-operative [post-op]) in both the groups. Thereafter from 2 to 12 h, the mean score increased to 4.92 (SD=2.72) in the CE group and 2.92 (SD=2.17) in the TAP group and the difference was statistically significant at 2 h, 4 h, 6 h, and 12 h postoperatively. Mean time to rescue analgesia in the CE group was 4.96 h (SD=4.32) and 5.52 h (SD=7.53) in the TAP group and difference was statistically significant (p=0.000). Mean total rescue analgesic requirement for the CE and TAP groups was 298.40 mg (SD=170.70) and 111.40 mg (SD=138.81) and the difference was also significant. Post-operative complications such as urinary retention and motor blockade were seen in 28% of CE patients, while none of the patients experienced post-operative nausea/vomiting. Conclusions: Our study showed significant increase in duration of post-operative analgesia among TAP patients with reduced requirement of rescue analgesics and lesser post-operative complications as compared to CE patients

The Effect of Vocabulary Intervention on Text Comprehension: Who Benefits?

2019 ◽  
Vol 50 (4) ◽  
pp. 562-578 ◽  
Author(s):  
Dawna Duff
Keyword(s):  
Middle School ◽  
Reading Comprehension ◽  
Text Comprehension ◽  
Classroom Instruction ◽  
Vocabulary Instruction ◽  
Clinical Intervention ◽  
Vocabulary Knowledge ◽  
Vocabulary Intervention ◽  
The Mean ◽  
The Difference

Purpose Vocabulary intervention can improve comprehension of texts containing taught words, but it is unclear if all middle school readers get this benefit. This study tests 2 hypotheses about variables that predict response to vocabulary treatment on text comprehension: gains in vocabulary knowledge due to treatment and pretreatment reading comprehension scores. Method Students in Grade 6 ( N = 23) completed a 5-session intervention based on robust vocabulary instruction (RVI). Knowledge of the semantics of taught words was measured pre- and posttreatment. Participants then read 2 matched texts, 1 containing taught words (treated) and 1 not (untreated). Treated texts and taught word lists were counterbalanced across participants. The difference between text comprehension scores in treated and untreated conditions was taken as a measure of the effect of RVI on text comprehension. Results RVI resulted in significant gains in knowledge of taught words ( d RM = 2.26) and text comprehension ( d RM = 0.31). The extent of gains in vocabulary knowledge after vocabulary treatment did not predict the effect of RVI on comprehension of texts. However, untreated reading comprehension scores moderated the effect of the vocabulary treatment on text comprehension: Lower reading comprehension was associated with greater gains in text comprehension. Readers with comprehension scores below the mean experienced large gains in comprehension, but those with average/above average reading comprehension scores did not. Conclusion Vocabulary instruction had a larger effect on text comprehension for readers in Grade 6 who had lower untreated reading comprehension scores. In contrast, the amount that children learned about taught vocabulary did not predict the effect of vocabulary instruction on text comprehension. This has implications for the identification of 6th-grade students who would benefit from classroom instruction or clinical intervention targeting vocabulary knowledge.

Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

2020 ◽  
Vol 33 (1) ◽  
pp. 41-47
Author(s):  
Mohsena Akhter ◽  
Ishrat Bhuiyan ◽  
Zulfiqer Hossain Khan ◽  
Mahfuza Akhter ◽  
Gulam Kazem Ali Ahmad ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Close Contact ◽  
Randomized Study ◽  
Sarcoptes Scabiei ◽  
Efficacy And Safety ◽  
Common Skin ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

EFFECTS OF SYNTHETIC LH/FSH-RELEASING HORMONE (LRH) ON PLASMA LH AND FSH IN AMENORRHOEIC WOMEN

1974 ◽  
Vol 75 (4) ◽  
pp. 647-652 ◽  
Author(s):  
G. Rannevik ◽  
J. Thorell
Keyword(s):  
Urinary Excretion ◽  
Initial Response ◽  
Releasing Hormone ◽  
The Mean ◽  
The Difference ◽  
Serial Measurements

ABSTRACT Eight amenorrhoeic women were given 100 μg synthetic LRH (Hoechst) iv and im, respectively, at an interval of 2 weeks. Four of the women received the iv injection first and four the im injection. The urinary excretion of oestrogens and pregnanediol was low and unaltered throughout the test weeks. The effects of LRH were compared by serial measurements of the plasma LH and FSH during 8 h. The initial response of LH for up to 25 min and that of FSH for up to 60 min were equal whether LRH was given iv or im. The difference appeared later. Four hours after the injection the mean increase of LH to iv injection was 0.5 ng/ml (N. S.), while that to im injection was 1.9 ng/ml (P < 0.01). The corresponding values for FSH were 1.3 (P < 0.05) and 3.2 (P < 0.001). The effect of LRH administration im was thus found to be larger and more prolonged.

Development of Prolonged Delivery of Tramadol and Dissolution Translation by Statistical Data Treatment

2011 ◽  
Vol 4 (1) ◽  
pp. 1331-1337
Author(s):  
P B Parejiya ◽  
B S Barot ◽  
P K Shelat
Keyword(s):  
Drug Release ◽  
Study Data ◽  
Stability Study ◽  
Dissolution Time ◽  
Matrix Tablet ◽  
Burst Effect ◽  
The Matrix ◽  
The Mean ◽  
The Difference ◽  
Dissolution Efficiency

The present study was carried out to fabricate a prolonged design for tramadol using Kollidon SR (Polyvinyl acetate and povidone based matrix retarding polymer). Matrix tablet formulations were prepared by direct compression of Kollidon SR of a varying proportion with a fixed percentage of tramadol. Tablets containing a 1:0.5 (Drug: Kollidon SR) ratio exhibited a rapid rate of drug release with an initial burst effect. Incorporation of more Kollidon SR in the matrix tablet extended the release of drug with subsequent minimization of the burst effect as confirmed by the mean dissolution time, dissolution efficiency and f2 value. Among the formulation batches, a direct relationship was obtained between release rate and the percentage of Kollidon SR used. The formulation showed close resemblance to the commercial product Contramal and compliance with USP specification. The results were explored and explained by the difference of micromeritic characteristics of the polymers and blend of drug with excipients. Insignificant effects of various factors, e.g. pH of dissolution media, ionic strength, speed of paddle were found on the drug release from Kollidon-SR matrix. The formulation followed the Higuchi kinetic model of drug release. Stability study data indicated stable character of Batch T6 after short-term stability study.

Seasonal trends in the stable isotopic composition of snow and meltwater runoff in a subarctic catchment at Okstindan, Norway

2004 ◽  
Vol 35 (2) ◽  
pp. 119-137 ◽  
Author(s):  
S.D. Gurney ◽  
D.S.L. Lawrence
Keyword(s):  
Isotopic Composition ◽  
Mean Value ◽  
Mean Values ◽  
Stable Isotopic Composition ◽  
Meltwater Runoff ◽  
Stable Isotopic ◽  
The Mean ◽  
The Difference ◽  
Δ18o And Δd

Seasonal variations in the stable isotopic composition of snow and meltwater were investigated in a sub-arctic, mountainous, but non-glacial, catchment at Okstindan in northern Norway based on analyses of δ18O and δD. Samples were collected during four field periods (August 1998; April 1999; June 1999 and August 1999) at three sites lying on an altitudinal transect (740–970 m a.s.l.). Snowpack data display an increase in the mean values of δ18O (increasing from a mean value of −13.51 to −11.49‰ between April and August), as well as a decrease in variability through the melt period. Comparison with a regional meteoric water line indicates that the slope of the δ18O–δD line for the snowpacks decreases over the same period, dropping from 7.49 to approximately 6.2.This change points to the role of evaporation in snowpack ablation and is confirmed by the vertical profile of deuterium excess. Snowpack seepage data, although limited, also suggest reduced values of δD, as might be associated with local evaporation during meltwater generation. In general, meltwaters were depleted in δ18O relative to the source snowpack at the peak of the melt (June), but later in the year (August) the difference between the two was not statistically significant. The diurnal pattern of isotopic composition indicates that the most depleted meltwaters coincide with the peak in temperature and, hence, meltwater production.

Study of pumping effect in flow-through electrolysers

1983 ◽  
Vol 48 (8) ◽  
pp. 2232-2248 ◽  
Author(s):  
Ivo Roušar ◽  
Michal Provazník ◽  
Pavel Stuhl
Keyword(s):  
Natural Convection ◽  
Balance Equation ◽  
Volume Fraction ◽  
Industrial Applications ◽  
Pumping Effect ◽  
Flow Through ◽  
The Mean ◽  
The Difference

In electrolysers with recirculation, where a gas is evolved, the pumping of electrolyte from a lower to a higher level can be effected by natural convection due to the difference between the densities of the inlet electrolyte and the gaseous emulsion at the outlet. An accurate balance equation for calculation of the rate of flow of the pumped liquid is derived. An equation for the calculation of the mean volume fraction of bubbles in the space between the electrodes is proposed and verified experimentally on a pilot electrolyser. Two examples of industrial applications are presented.

Propensity-adjusted cost analysis of radial versus femoral access for neuroendovascular procedures

2020 ◽  
pp. neurintsurg-2020-016728
Author(s):  
Joshua S Catapano ◽  
Andrew F Ducruet ◽  
Stefan W Koester ◽  
Tyler S Cole ◽  
Jacob F Baranoski ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Hospital Costs ◽  
Length Of Hospital Stay ◽  
Diagnostic Procedures ◽  
Femoral Access ◽  
Catheter Size ◽  
The Mean ◽  
The Difference ◽  
Procedure Type ◽  
Angiographic Findings

BackgroundTransradial artery (TRA) access for neuroendovascular procedures is associated with fewer complications than transfemoral artery (TFA) access. This study compares hospital costs associated with TRA access to those associated with TFA access for neurointerventions.MethodsElective neuroendovascular procedures at a single center were retrospectively analyzed from October 1, 2018 to May 31, 2019. Hospital costs for each procedure were obtained from the hospital financial department. The primary outcome was the difference in the mean hospital costs after propensity adjustment between patients who underwent TRA compared with TFA access.ResultsOf the 338 elective procedures included, 63 (19%) were performed through TRA versus 275 (81%) through TFA access. Diagnostic procedures were more common in the TRA cohort (51 of 63, 81%) compared with the TFA cohort (197 of 275, 72%), but the difference was not significant (p=0.48). The TRA cohort had a shorter length of hospital stay (mean (SD) 0.3 (0.5) days) compared with the TFA cohort (mean 0.7 (1.3) days; p=0.02) and lower hospital costs (mean $12 968 ($6518) compared with the TFA cohort (mean $17 150 ($10 946); p=0.004). After propensity adjustment for age, sex, symptoms, angiographic findings, procedure type, sheath size, and catheter size, TRA access was associated with a mean hospital cost of $2514 less than that for TFA access (95% CI −$4931 to −$97; p=0.04).ConclusionNeuroendovascular procedures performed through TRA access are associated with lower hospital costs than TFA procedures. The lower cost is likely due to a decreased length of hospital stay for TRA.

Estimating Utility Values for Health States of DFU Patients Using EQ-5D-5L and cTTO

2021 ◽  
pp. 153473462110143
Author(s):  
Morteza Arab-Zozani ◽  
Hossein Safari ◽  
Zoha Dori ◽  
Somayeh Afshari ◽  
Hosein Ameri ◽  
...  
Keyword(s):  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Economic Modeling ◽  
Health State ◽  
Health States ◽  
Utility Values ◽  
The Mean ◽  
The Difference ◽  
Diabetes Center ◽  
Health State Utility Values

Health-state utility values of diabetic foot ulcer (DFU) patients are necessary for clinical praxis and economic modeling. The purpose of this study was to estimate utility values in DFU patients using the EuroQol-5-dimension-5-level (EQ-5D-5L) and composite time trade-off (cTTO). The EQ-5D-5L and cTTO were used for estimating utility values. Data were collected from 228 patients referred to the largest governmental diabetes center in the South of Iran, Yazd province. When appropriate, independent sample t-test or analysis of variance test was used to test the difference in the utility values in each of the demographic and clinical characteristics of the patients. Finally, the BetaMix was used to identify predictors of the utility values. The means of EQ-5D-5L and cTTO values were 0.55( SD 0.21) and 0.67( SD 0.23), respectively. Anxiety and pain were the most common problems reported by the patients. The difference between the mean EQ-5D-5L values was significant for age, grade of ulcer, number of comorbidities, and having complications. In addition, variables of gender, age, grade of ulcer, and having complications were significant predictors of the EQ-5D-5L. The difference between the mean cTTO values was significant for age, employment status, grade of ulcer, number of comorbidities, and having complications. Moreover, variables of gender, age, grade of ulcer, number of comorbidities, and developing complications were significant predictors of cTTO. The current study provided estimates of utility values for DFU patients for clinical praxis and economic modeling. These estimates, similar to utilities reported in other studies, were low. Identifying strategies to decrease anxiety/depression and pain in patients is important to improve the utility values.

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