The role of imaging tests in electrotherapy

2020 ◽  
Vol 1 (54) ◽  
pp. 23-29
Author(s):  
Łukasz Mazurek ◽  
Agnieszka Kotalczyk ◽  
Michał Mazurek ◽  
Ewa Jędrzejczyk-Patej
Keyword(s):  
Sensitivity And Specificity ◽  
Therapeutic Process ◽  
Electronic Devices ◽  
Diagnosis And Treatment ◽  
Imaging Methods ◽  
Cardiac Implantable Electronic Devices ◽  
Wide Range

We currently have a wide range of different imaging tests that are constantly improving and developing. Each test has its sensitivity and specificity and is used in various fields of medicine. Knowledge of the possibilities of using imaging tests in electrotherapy is an important element of the diagnostic and therapeutic process. This article presents selected issues regarding the use of imaging methods in the diagnosis and treatment of patients with cardiac implantable electronic devices.

scholarly journals 332 The diagnostic role of shunt series radiographs (SSR) in children presenting to the children’s emergency department (CED) with suspected ventriculoperitoneal (VP) shunt failure

2020 ◽  
Vol 37 (12) ◽  
pp. 852.3-853
Author(s):  
Angharad Griffiths ◽  
Ikechukwu Okafor ◽  
Thomas Beattie
Keyword(s):  
Clinical Outcome ◽  
Sensitivity And Specificity ◽  
Clinical Information ◽  
Flow Diagram ◽  
List Type ◽  
Shunt Failure ◽  
Vp Shunt ◽  
Wide Range ◽  
Diagnostic Role

Aims/Objectives/BackgroundVP shunts are used to drain CSF from the cranial vault because of a wide range of pathologies and, like any piece of hardware, can fail. Traditionally investigations include SSR and CT. This project examines the role of SSR in evaluating children with suspected VP shunt failure.Primary outcome: Sensitivity and specificity of SSR in children presenting to the CED with concern for shunt failure.Methods/DesignConducted in a single centre, tertiary CED of the national Irish Neurosurgical(NS) referral centre (ED attendance:>50,000 patients/year). 100 sequential SSR requested by the CED were reviewed. Clinical information was extracted from electronic requests. Shunt failure was defined by the need for NS intervention(Revision).Abstract 332 Figure 1Abstract 332 Figure 2Results/ConclusionsSensitivity and specificity is presented in figure 1 (two by two table).100 radiographs performed in 84 children.22% shunts revised (see flow diagram).7 SSR’s were abnormal.85% (n=6) shunts revised. [5 following abnormal CT].Of the normal SSR’s; 16 had abnormal CT and revised.85/100 received CT.64 of 85 CT’s (75%) were normal.□6 of the 64 had focal shunt concern.SSR’s shouldn’t be used in isolation. NPV&PPV, Sensitivity&Specificity is low.SSR’s are beneficial where there’s concern over focal shunt problems (injury/pain/swelling) or following abnormal CT.VP shunt failure is not well investigated with SSR alone.SSR’s could be omitted where there is no focal shunt concern/after normal CT (without impacting clinical outcome) reducing radiation exposure and reduce impact on CED’s.59 SSR’s could have been avoided without adverse clinical outcome.

scholarly journals Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) – a case report and a review of the latest scientific reports

2020 ◽  
Vol 21 (4) ◽  
pp. 178-186
Author(s):  
Dariusz Dziubek ◽  
◽  
Mateusz Rajchel ◽  
Barbara Stańko-Kałamarz ◽  
Mirosław Dziki
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Maintenance Therapy ◽  
Steroid Therapy ◽  
Treatment Strategy ◽  
Therapeutic Process ◽  
Acute Disease ◽  
Diagnosis And Treatment ◽  
Recommended Treatment

The paper presents a case of a 61-year-old patient with chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS), along with a detailed description of the diagnostic and therapeutic process, as well as radiological records reflecting the evolution of lesions depending on the steroid therapy used. We also refer to the latest literature reports on the aetiology, pathogenesis, diagnosis and treatment of this clinical entity, including its potential relationship with lymphoproliferative and lymphohistiocytic processes. Furthermore, we present a spectrum of diseases that can clinically and radiologically mimic CLIPPERS (CLIPPERS-mimics), along with the proposed differential diagnosis. Finally, the paper presents the recommended treatment strategy for both acute disease and a maintenance therapy, with particular emphasis on the role of steroid therapy.

scholarly journals Infected cardiac-implantable electronic devices: prevention, diagnosis, and treatment

2015 ◽  
Vol 36 (37) ◽  
pp. 2484-2490 ◽  
Author(s):  
Jens Cosedis Nielsen ◽  
Jens Christian Gerdes ◽  
Niraj Varma
Keyword(s):  
Electronic Devices ◽  
Diagnosis And Treatment ◽  
Cardiac Implantable Electronic Devices

Renal Transplant Complications: Diagnostic and Therapeutic Role of Radiology

2014 ◽  
Vol 65 (3) ◽  
pp. 242-252 ◽  
Author(s):  
Mehmet Fatih Inci ◽  
Fuat Ozkan ◽  
Teik Choon See ◽  
Servet Tatli
Keyword(s):  
Renal Transplantation ◽  
Surgical Techniques ◽  
Diagnosis And Treatment ◽  
Tubular Necrosis ◽  
Transplantation Surgery ◽  
Wide Range ◽  
Transplantation Complications ◽  
Fluid Collections ◽  
Vein Stenosis

Kidney was the first and is the most frequently transplanted organ. Despite improved surgical techniques and transplantation technology, complications do occur and, if left untreated, may lead to catastrophic consequences. Renal transplantation complications may be vascular (eg, renal artery and vein stenosis and thrombosis, arteriovenous fistula, and pseudoaneurysms); urologic (eg, urinary obstruction and leak, and peritransplantation fluid collections, including hematoma, seroma, lymphocele, and abscess formation); and nephrogenic, including acute tubular necrosis, graft rejection, chronic allograft nephropathy, and neoplasm. Early diagnosis and treatment of these complications are paramount to prevent graft failure and other significant morbidities to the patients. Radiology plays a pivotal role in the diagnosis and treatment of these complications, with minimally invasive percutaneous techniques. In this article, we reviewed renal transplantation anatomy, a wide range of complications that may occur after renal transplantation surgery, typical imaging appearances of the complications on varies imaging modalities, and percutaneous interventional techniques that are used in their treatment.

Role of Surface Electrocardiograms in Patients with Cardiac Implantable Electronic Devices

2018 ◽  
Vol 10 (2) ◽  
pp. 233-255
Author(s):  
Emanuela T. Locati ◽  
Giuseppe Bagliani ◽  
Alessio Testoni ◽  
Maurizio Lunati ◽  
Luigi Padeletti
Keyword(s):  
Electronic Devices ◽  
Cardiac Implantable Electronic Devices

scholarly journals Influence of the type of pathogen on the clinical course of infectious complications related to cardiac implantable electronic devices

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anna Polewczyk ◽  
Wojciech Jacheć ◽  
Luca Segreti ◽  
Maria Grazia Bongiorni ◽  
Andrzej Kutarski
Keyword(s):  
Clinical Course ◽  
Electronic Devices ◽  
High Volume ◽  
Infectious Complications ◽  
Lead Extraction ◽  
Gram Positive ◽  
Cardiac Implantable Electronic Devices ◽  
Long Term Prognosis

AbstractThe specific role of the various pathogens causing cardiac implantable electronic devices-(CIEDs)-related infections requires further understanding. The data of 1241 patients undergoing transvenous lead extraction because of lead-related infective endocarditis (LRIE-773 patients) and pocket infection (PI-468 patients) in two high-volume centers were analyzed. Clinical course and long-term prognosis according to the pathogen were assessed. Blood and generator pocket cultures were most often positive for methicillin-sensitive Staphylococcus aureus (MSSA: 22.19% and 18.13% respectively), methicillin-sensitive Staphylococcus epidermidis (MSSE: 17.39% and 15.63%) and other staphylococci (11.59% and 6.46%). The worst long-term prognosis both in LRIE and PI subgroup was in patients with infection caused by Gram-positive microorganisms, other than staphylococci. The most common pathogens causing CIED infection are MSSA and MSSE, however, the role of other Gram-positive bacteria and Gram-negative organisms is also important. Comparable, high mortality in patients with LRIE and PI requires further studies.

Influence of Mannose Binding Lectin (MBL) Gene Polymorphisms on Infectious Complications during Treatment for Childhood Malignancy.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 1260-1260
Author(s):  
Rachel M. Dommett ◽  
Mona Bajaj-Elliott ◽  
Julia Chisholm ◽  
Nigel Klein
Keyword(s):  
High Risk ◽  
Infectious Complications ◽  
Mannose Binding Lectin ◽  
Diagnosis And Treatment ◽  
Study Cohort ◽  
Wide Range ◽  
Mannose Binding ◽  
Binding Lectin ◽  
Mbl Deficiency

Abstract Infection remains a major cause of morbidity and hospitalisation in children receiving chemotherapy. At present clinical parameters provide a guide to risk of severe infection but it has become increasingly apparent that, among patients with the same diagnosis and treatment regimen, not all suffer equally from infectious complications. Mannose binding lectin is a pattern recognition molecule of the innate immune system which, upon binding to a wide range of microorganisms, activates the lectin pathway of complement. Polymorphisms in the MBL2 gene result in low levels of MBL protein and are frequently associated with increased susceptibility to infection. Studies investigating the role of MBL in defence against infection following chemotherapy have reported conflicting findings to date. MBL replacement therapy is a potential treatment option in the future and we consider it imperative that we clarify the role of MBL in this clinical setting. Clinical data from episodes of febrile neutropenia (FN) in children aged 0−16 receiving chemotherapy for childhood cancer was recorded prospectively from April 2004−March 2005, including clinical and microbiological evidence of infection, antibiotic days and duration of admission. MBL genotyping was performed using a reverse hybridisation technique and results were analysed against FN outcome. 269 children were recruited into the study. A total of 513 episodes of FN were captured over the study period from 211 patients. 58 patients had no recorded episodes of FN. There was no association between age, sex, ethnicity or diagnosis and MBL genotype. 75% of subjects had a haematological malignancy and of these 84% had acute lymphoblastic leukaemia (ALL). Overall, patients with MBL2 polymorphisms experienced more episodes of FN than wildtype individuals (median 2 and 1, respectively, p=0.074). Analysis of episodes with documented clinical/microbiological infection revealed that the proportion of patients with ≥ 3 episodes was 14.6% in those with polymorphisms and 8% in wildtype, p=0.045. This trend was also true for the supgroup of patients with ALL. The duration of inpatient stay for FN, used as a surrogate measure of severity, was influenced by MBL genotype in some groups of patients. Longer inpatient stays and antibiotic days were most apparent in the MBL deficient patients with high risk diagnoses e.g. AML and B NHL who spent up to 4.5 days longer/per episode in hospital than high risk wildtype patients. These results suggest that MBL deficiency influences both susceptibility to FN and outcome of FN episodes in this study cohort. The effect of MBL deficiency differs between diagnostic groups and may be most important in those patients who are at higher risk of severe FN by virtue of their underlying diagnosis and treatment regime.

scholarly journals Role of imaging methods in diagnosis and treatment of Morton’s neuroma

2018 ◽  
Vol 10 (9) ◽  
pp. 91-99 ◽  
Author(s):  
Fernando Ruiz Santiago ◽  
Pablo Tomás Muñoz ◽  
Patel Pryest ◽  
Alberto Martinez Martínez ◽  
Nicolás Prados Olleta
Keyword(s):  
Diagnosis And Treatment ◽  
Morton’S Neuroma ◽  
Imaging Methods ◽  
Morton's Neuroma
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