Imaging for Nephrolithiasis

2017 ◽  
Author(s):  
Daniel A Wollin ◽  
Joanne Dale ◽  
Ruiyang Jiang ◽  
Stephanie Sexton ◽  
Glenn M Preminger
Keyword(s):  
Imaging Technique ◽  
Radiation Doses ◽  
Digital Tomosynthesis ◽  
Common Condition ◽  
Intravenous Pyelography ◽  
Imaging Diagnosis ◽  
Ct Diagnosis ◽  
Adequate Treatment ◽  
Key Words Ct

Nephrolithiasis is a common condition that affects a large number of Americans. An imaging diagnosis is required for adequate treatment and follow-up, and a large variety of imaging modalities exist for this purpose. In this review, we discuss the advantages, disadvantages, and specific uses for a wide array of imaging methods, including plain radiography, ultrasonography, CT, and others. In addition, special attention is paid to specific clinical situations for individual tests, such as when dealing with children, pregnant women, and patients in an intraoperative setting. Approximate costs and radiation doses of each modality are discussed as well. At the conclusion of this review, the reader should understand the utility of each imaging technique, along with the optimal situation for use and reasoning for these decisions. This review contains 5 highly rendered figures, 2 tables, and 85 references Key words: CT, diagnosis, digital tomosynthesis, fluoroscopy, follow-up, imaging, intravenous pyelography, MRI, nephrolithiasis, radiation dose, radiography, ultrasonography

Imaging for Nephrolithiasis

2017 ◽  
Author(s):  
Daniel A Wollin ◽  
Joanne Dale ◽  
Ruiyang Jiang ◽  
Stephanie Sexton ◽  
Glenn M Preminger
Keyword(s):  
Imaging Technique ◽  
Radiation Doses ◽  
Digital Tomosynthesis ◽  
Common Condition ◽  
Intravenous Pyelography ◽  
Imaging Diagnosis ◽  
Ct Diagnosis ◽  
Adequate Treatment ◽  
Key Words Ct

Nephrolithiasis is a common condition that affects a large number of Americans. An imaging diagnosis is required for adequate treatment and follow-up, and a large variety of imaging modalities exist for this purpose. In this review, we discuss the advantages, disadvantages, and specific uses for a wide array of imaging methods, including plain radiography, ultrasonography, CT, and others. In addition, special attention is paid to specific clinical situations for individual tests, such as when dealing with children, pregnant women, and patients in an intraoperative setting. Approximate costs and radiation doses of each modality are discussed as well. At the conclusion of this review, the reader should understand the utility of each imaging technique, along with the optimal situation for use and reasoning for these decisions. This review contains 5 highly rendered figures, 2 tables, and 85 references Key words: CT, diagnosis, digital tomosynthesis, fluoroscopy, follow-up, imaging, intravenous pyelography, MRI, nephrolithiasis, radiation dose, radiography, ultrasonography

The Employment of 197Hg EDTA in Kidney Scanning

1965 ◽  
Vol 05 (01) ◽  
pp. 56-67
Author(s):  
I. Pál ◽  
J. Földes ◽  
I. Krasznai
Keyword(s):  
Radiation Dose ◽  
Renal Cortex ◽  
Radiation Doses ◽  
Intravenous Pyelography ◽  
Edta Complex

SummaryThe authors investigated the use of 197Hg EDTA complex for kidney scanning. They describe the physical, biological and toxicological properties of the compound; its distribution within the organism, its excretion with urine and faeces and its uptake by the kidneys. The authors have established that the renal cortex selectively secretes the material which makes it suitable for kidney scanning. Some scintigrams of both normal and pathologic kidneys are presented.Finally a detailed discussion of the dosimetry is included. The radiation doses due to 197Hg EDTA are compared with those due to 203Hg-neohydrin and to intravenous pyelography. This comparison shows clearly that the use of 197Hg EDTA considerably decreases the radiation dose to the patient.

scholarly journals Perspectives and experiences of people who were randomly assigned to wait-and-see approach in a gluteal tendinopathy trial: a qualitative follow-up study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044934
Author(s):  
Melanie Louise Plinsinga ◽  
Rebecca Mellor ◽  
Jenny Setchell ◽  
Kelsie Ford ◽  
Leonard Lynch ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Corticosteroid Injection ◽  
Imaging Diagnosis ◽  
Parallel Group ◽  
Data Collection And Analysis ◽  
Gluteal Tendinopathy ◽  
Semistructured Interviews ◽  
Registration Number ◽  
Wait And See

ObjectiveTo explore participants’ perspectives on, and experiences of, being assigned to a wait-and-see arm of a gluteal tendinopathy trial.DesignDescriptive qualitative.SettingGeneral community in Brisbane and Melbourne, Australia.ParticipantsFifteen participants who had been randomly allocated to the wait-and-see group in a recent parallel group superiority clinical trial. That trial compared the wait-and-see approach to a physiotherapist-led education plus exercise approach, and an ultrasound-guided corticosteroid injection. The wait-and-see approach involved one physiotherapy session in which participants received reassurance, general advice and encouragement to stay active for the management of gluteal tendinopathy.Data collection and analysisSemistructured interviews were conducted by four interviewers in person or over the internet, audio recorded and transcribed verbatim. Transcripts were coded and data analysed using an inductive thematic approach.ResultsFive themes were extracted from the interview transcripts: (1) Feeling disenfranchised by being assigned to a wait-and-see approach; (2) the importance of having a clinical and imaging diagnosis during screening for inclusion into the clinical trial; (3) feelings regarding the effectiveness of the approach; (4) the convenient and easy to follow nature of the wait-and-see approach and (5) the connotation of wait-and-see not always being perceived as an intervention.ConclusionsParticipants found the wait-and-see approach convenient and easy to follow, yet almost always felt disenfranchised that nothing was being done. Participants highlighted the importance of a definite clinical and imaging diagnosis.Trial registration numberACTRN12612001126808; Post-results.

Long-Term Outcomes of Patients with Hydrocephalus Secondary to Tectal Plate Glioma versus Idiopathic Aqueductal Stenosis: Results from a Single Center

2021 ◽  
pp. 1-11
Author(s):  
Hamid Reza Niknejad ◽  
Melissa Frederickx ◽  
Emiel Salaets ◽  
Jurgen Lemiere ◽  
Lieven Lagae ◽  
...  
Keyword(s):  
Aqueductal Stenosis ◽  
Maximum Diameter ◽  
Benign Tumors ◽  
Term Outcome ◽  
Adequate Treatment ◽  
Long Term Outcome ◽  
Tectal Plate ◽  
The Mean

<b><i>Introduction:</i></b> Tectal plate gliomas (TPG) constitute a distinct entity of benign tumors of the brain stem which show an indolent clinical course. Adequate treatment of secondary hydrocephalus is undoubtedly a major factor in the outcome. However, little is known about to what degree the tumor itself determines the long-term outcome of these patients. <b><i>Methods:</i></b> We retrospectively analyzed and compared the clinical and radiological data of 16 pediatric TPG patients with data of 12 pediatric idiopathic aqueductal stenosis (IAS) patients treated in our center from 1988 to 2018. For both groups, we assessed the long-term outcome in terms of hydrocephalus management, and for the TPG group, we assessed tumor growth during follow-up. In a separate prospective part of the study, we performed a neuropsychological evaluation in a subgroup of patients using a standardized testing battery, covering intelligence, learning, memory, executive functions, and an inventory on depression. <b><i>Results:</i></b> In the TPG group, the mean clinical and radiological follow-up was 84 and 70 months, respectively. On average, the maximum diameter of the tumor increased by 11% (<i>p</i> = 0.031) and the estimated tumor volume with 35% (<i>p</i> = 0.026) on radiological follow-up. The fronto-occipital horn ratio (FOHR) decreased by 23% on average after treatment. In the IAS group, the mean clinical and radiological follow-up was 117 and 85 months, respectively. In this group, the FOHR decreased by 21% on average. Neurocognitive testing revealed significant higher scores in the TPG group on global intelligence (TPG = 109, IAS = 85.5, <i>U</i> = 3, <i>p</i> &#x3c; 0.01, <i>z</i> = −2.71), performance (TPG= 100, IAS = 85, <i>U</i> = 7, <i>p</i> = 0.03, <i>z</i> = −2.2), and verbal intelligence (TPG = 122, IAS = 91.5, <i>U</i> = 2, <i>p</i> &#x3c; 0.00, <i>z</i> = −2.87) as well as working memory (TPG = 109.5, IAS = 77, <i>U</i> = 0.5, <i>p</i> = 0.01, <i>z</i> = −2.46). <b><i>Conclusion:</i></b> Our results suggest that the long-term outcome in TPG patients is acceptable and that cognition is substantially better preserved than in patients with IAS. This puts the idea of a significant contribution of the tumoral mass to disease outcome on the long term in question. Adequate and prompt management of hydrocephalus is the most important factor in long-term cognitive outcome.

Solitary Ovarian Plasmocytoma: A Rare localization of Extramedullary Plasmocytoma. A Case Report

2021 ◽  
Vol 4 (5) ◽  
pp. 01-04
Author(s):  
Salma Fares ◽  
Adil Taoufik ◽  
Aissam Maataoui ◽  
Kaoutar Sokori ◽  
Ouadie Qamouss
Keyword(s):  
Plasma Cells ◽  
Female Genital Tract ◽  
Malignant Neoplasm ◽  
Solitary Plasmacytoma ◽  
Adequate Treatment ◽  
Complete Surgical Resection ◽  
Plasma Cell Dyscrasias ◽  
Extramedullary Plasmocytoma ◽  
Work Up

Background: Solitary plasmacytoma is a rare malignant neoplasm of plasma cells accounting 5-10% of all plasma cell dyscrasias with extramedullary plasmocytoma in 3- 5%. Their localization in the female genital tract is quite rare, either as solitary plasmacytomas or as part of a disseminated MM. Solitary ovarian plasmocytoma is extremely rare. Case: A 52-year-old woman, presented presented postmenopausal recurring episodes of metrorrhagia with left ovarian mass. She was diagnosed with solitary ovarianplasmocytoma without systemicdisease. The patient underwent complete surgery resection and a full work up to rule out multiple myeloma that objectived a small serum monoclonal protein that had resolved postoperatively. At 17 months of follow-up, the patient is still alive and doing well with no signs of recurrence or progression to mutliple myeloma. Although rare, solitary plasmacytoma of the ovary can occur without any overt symptoms or laboratory abnormalities tests and require prompt and adequate treatment and rigorous monitoring due to their ability to relapse or progress to MM. Complete surgical resection followed by activesurveillance is appropriate.

Eye protection in interventional procedures

2021 ◽  
Vol 94 (1126) ◽  
pp. 20210436 ◽  
Author(s):  
Beth A. Schueler ◽  
Kenneth A Fetterly
Keyword(s):  
Interventional Procedures ◽  
Eye Lens ◽  
Radiation Doses ◽  
Radiation Induced ◽  
Individual Actions ◽  
Dose Measurements ◽  
Dose Levels ◽  
Patient Radiation Dose ◽  
Low Radiation Doses

Data suggest that radiation-induced cataracts may form without a threshold and at low-radiation doses. Staff involved in interventional radiology and cardiology fluoroscopy-guided procedures have the potential to be exposed to radiation levels that may lead to eye lens injury and the occurrence of opacifications have been reported. Estimates of lens dose for various fluoroscopy procedures and predicted annual dosages have been provided in numerous publications. Available tools for eye lens radiation protection include accessory shields, drapes and glasses. While some tools are valuable, others provide limited protection to the eye. Reducing patient radiation dose will also reduce occupational exposure. Significant variability in reported dose measurements indicate dose levels are highly dependent on individual actions and exposure reduction is possible. Further follow-up studies of staff lens opacification are recommended along with eye lens dose measurements under current clinical practice conditions.

HYPOTHYROIDISM IN PREGNANCY -SIGNIFICANCE OF ADEQUATE TREATMENT: A STUDY OF 100 CASES IN NORTH BIHAR

2021 ◽  
pp. 40-41
Author(s):  
Vasudha Rani ◽  
Punam Kumari
Keyword(s):  
Post Partum ◽  
Adverse Outcomes ◽  
Endocrine Disorders ◽  
Potential Threat ◽  
Adequate Treatment ◽  
Antibody Positivity ◽  
Prompt Diagnosis ◽  
In Pregnancy

Pregnancy is a nature's gift of humanity for procreation and continuation of its race. This gift is however fraught with several complications and has potential threat to the mother and the foetus. When pregnancy is compounded by endocrine disorders such as hypothyroidism, the potential for maternal and foetal adverse outcomes can be immense. While a lot of attention has been focused on the adverse foetal outcomes consequent to hypothyroidism, attention is also being gradually directed towards the adverse maternal outcomes of this disorder. Role of antibody positivity in inuencing outcomes in a euthyroid woman, also needs further clarication. Prompt diagnosis and treatment of hypothyroidism in pregnancy is very essential. Subclinical hypothyroidism also needs to be detected and treated to prevent adverse outcomes, especially maternal. Since women with hypothyroidism during pregnancy, especially of the autoimmune variety might have a are up of the disorder post-partum, or might continue to require thyroxine replacement post-partum, adequate follow-up is mandatory. While targeted case nding is generally practised, recent evidence seems to indicate that universal screening might be a better option. In conclusion, routine screening, early conrmation of diagnosis and prompt treatment allied with regular post-partum follow up, is required to ensure favourable maternal and foetal outcomes.

scholarly journals Complications in Treatment of 31-A Fractures with Trochanteric Gamma Nail (TGN) Versus Gamma3 Nail (G3N) - A Review of 217 Cases

2016 ◽  
Vol 10 (1) ◽  
pp. 389-395 ◽  
Author(s):  
R. Schupfner ◽  
L.T. Käsmann ◽  
W. Wagner ◽  
A.P. Schulz
Keyword(s):  
Complication Rate ◽  
Statistical Significance ◽  
Gamma Nail ◽  
Consecutive Series ◽  
Related Complication ◽  
Surgical Time ◽  
Adequate Treatment ◽  
Femur Fractures ◽  
Two Generations

Introduction:The aim of this study was to clinically evaluate two generations of intramedullary gamma-nail used in the treatment of 31-A femur fractures.Materials and Methods:In two consecutive series, 117 trochanteric gamma nails (TGN) and 100 Gamma3 nails (G3N) were implanted for the treatment of inter- and subtrochanteric fractures between 2009 and 2011. Clinical and radiological follow-up examinations were assessed. An analysis of surgical time, hemoglobin drop and complications were performed.Results:Average surgical time, fluoroscopy time, haemoglobin drop and length-of-stay (LOS) were similar in both groups. No significant differences were found in surgery-related complications like wound hematomas (p=0,59), abscesses (p=0,38), wound infections (p=0,69) and Cut-outs (p=0,69) between the two groups. The cumulative surgery-related complication rate was higher in the TGN group compared to the G3N group (13,68%vs.8%) but this did not reach statistical significance (p=0,2).Conclusion:Our findings suggest that both TGN and G3N allow adequate treatment of trochanteric fractures with an acceptable complication rate.

scholarly journals Endovascular Treatment of Isolated Chronic Abdominal Aortic Dissection

2016 ◽  
Vol 29 (3) ◽  
pp. 224
Author(s):  
Rui Machado ◽  
Duarte Rego ◽  
Luís Loureiro ◽  
Rui Almeida
Keyword(s):  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Rare Event ◽  
Endovascular Intervention ◽  
Adequate Treatment ◽  
Initial Surgery ◽  
Abdominal Aortic ◽  
Long Term Follow Up ◽  
Abdominal Aortic Dissection

Isolated acute abdominal aortic dissection is a relatively rare event. Its natural history is not fully understood and its optimal treatment is not established. Open surgery represents the most described treatment but endovascular intervention has had increasing application. Isolated chronic abdominal aortic dissection  is even less described in the literature. We describe three patients with isolated chronic abdominal aortic dissection who underwent endovascular treatment in our institution. Mean age at presentation was 82 years. Indication for surgical intervention was aneurismal degeneration. Mean aortic diameter at presentation was 46.7 mm. There was no perioperative mortality or reinterventions. Mean follow-up was 5.3 years (2-12 years). Late reintervention was needed in one patient, eight years after initial surgery, due to type 1 endoleak. According to our experience, endovascular intervention represents an effective and durable treatment option in isolated chronic abdominal aortic dissection. However, long-term follow-up is mandatory. Furthermore, larger studies are still needed to understand this disease and its adequate treatment.

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