BACKGROUND: Many studies suggest that impairment of motor control is the mechanical component of the pathogenesis of painful disorders in the lumbo-sacral region; however, this theory is still unproven and the results and recommendations for intervention remain questionable. The need for a force to compress both innominate bones against the sacrum is the basis for treatment of pregnancy-related pelvic girdle pain (PGP). Therefore, it is advised to use a pelvic belt and do exercises to enhance contraction of the muscles which provide this compression. However, our clinical experience is that contraction of those muscles appears to be excessive in PGP. Therefore, in patients with long-lasting pregnancy-related posterior PGP, there is a need to investigate the contraction pattern of an important muscle that provides a compressive force, i.e. the transverse abdominal muscle (TrA), during a load transfer test, such as active straight leg raising (ASLR).
METHODS: TrA thickness was measured by means of ultrasound imaging at rest and during ASLR in 43 non-pregnant women with ongoing posterior PGP that started during a pregnancy or delivery, and in 39 women of the same age group who had delivered at least once and had no current PGP (healthy controls).
RESULTS: In participants with PGP, the median TrA thickness increase with respect to rest during ipsilateral and contralateral ASLR was 31% (SD 46%) and 31% (SD 57%), respectively. In healthy controls, these values were 11% (SD 25%) and 13% (SD 22%), respectively.
CONCLUSIONS: Significant excessive contraction of the TrA is present during ASLR in patients with long-lasting pregnancy-related posterior PGP. The present findings do not support the idea that contraction of the TrA is decreased in long-lasting pregnancy-related PGP. This implies that there is no rationale for the prescription of exercises to enhance contraction of TrA in patients with long-lasting pregnancy-related PGP.
PURPOSE: To describe anatomic sites of recurrence among prostate cancer patients with biochemical recurrence following radical prostatectomy (RP) and postoperative radiotherapy (RT) and/or androgen deprivation therapy (ADT) using (11)C-Choline PET/CT and multiparametric-MRI.
MATERIALS AND METHODS: RP patients evaluated with (11)C-Choline PET/CT and multiparametric-MRI following RT and/or ADT were evaluated for patterns of recurrence and clinicopathologic features. Recurrent sites were described as either local-only (seminal vesicle bed/prostate fossa, vesicourethral anastomosis and bladder neck) or distant metastatic disease. Features associated with identification of any distant metastatic disease were evaluated using multivariable logistic regression.
RESULTS: A total of 550 patients were identified. Treatment included 108 with ADT, 201 with RT, and 241 with both. Median PSA at evaluation was 3.9, 3.6, and 2.8 ng/mL for patients treated with ADT, RT, or a combination, respectively. 77 patients (14%) recurred locally, 411 (75%) recurred with distant metastasis only, and 62 (11%) recurred with both local and distant metastatic disease. On multivariable analysis, treatment with radiotherapy (OR 7.18; 95%CI 2.92-17.65; p<0.01) and radiotherapy and hormonal therapy (OR 9.23; 95%CI 3.90-21.87; p<0.01) were associated with an increased odds of distant failure at evaluation.
CONCLUSIONS: The combination of (11)C-choline PET/CT and multiparametric-MRI successfully identified patterns of recurrence following postoperative RT, ADT, or both, at median PSA less than 4. Half of this cohort had local only recurrence and/or low disease burden limited to pelvic lymph nodes and may benefit from additional local therapy. This data and analysis may facilitate the evaluation of such patients with biochemically recurrent prostate cancer.
BACKGROUND: Early abdominal computed tomography (CT) or magnetic resonance (MR) imaging is common in acute pancreatitis (AP). Guidelines (2007-2013) indicate routine use is unwarranted.
AIMS: To compare the frequency and evaluate the predictors of early CT/MR utilization for AP between September 2006-2007 (period A) and September 2014-2015 (period B).
METHODS: AP patients presenting directly to a large academic emergency department were prospectively enrolled during each period. Cases requiring imaging to fulfill diagnostic criteria were excluded. Early CT/MR (within 24 h of presentation) utilization rates were compared using Fisher's exact test. Predictors of early imaging usage were assessed with multivariate logistic regression.
RESULTS: The cohort included 96 AP cases in period A and 97 in period B. There were no significant differences in patient demographics, comorbidity scores, or AP severity. Period B cases manifested decreased rates of the systemic inflammatory response syndrome (SIRS) during the first 24 h of hospitalization (67% period A vs. 43% period B, p = 0.001). Independent predictors of early imaging included age >60 and SIRS or organ failure on day 1. No significant decrease in early CT/MR usage was observed from period A to B on both univariate (49% period A vs. 40% period B, p = 0.25) and multivariate (OR 1.0 for period B vs. A, 95% CI 0.5-1.9) analysis.
CONCLUSIONS: In a comparison of imaging practices for AP, there was no significant decrease in early abdominal CT/MR utilization from 2007 to 2015. Quality improvement initiatives specifically targeting early imaging overuse are needed.
Pancreatitis (2), Systemic Inflammatory Response Syndrome (1), more mentions
... and accuracy of low-dose CT scan in comparison with standard dose.In this prospective study, suspected body stuffers who were referred to the radiology department underwent two different protocols of abdominal non-contrast CT scan simultaneously: low-dose (with equivalent dose to conventional abdominalx-ray) and standard dose.
Diagnosis is typically made via direct visualization intraoperatively and therefore treatment is usually surgical.We present a case of spontaneous bilateral tubal ectopic pregnancies diagnosed 7 days apart via transvaginalultrasound. The patient presented to the emergency department with pelvic pain on the contralateral side of her previously diagnosed ectopic pregnancy and vaginal spotting.
... capable of "reading" full-text radiology reports to accurately identify the presence of fatty liver disease. Abdominalultrasound, computerized tomography, and magnetic resonance imaging reports were retrieved from the Veterans Affairs Corporate Data Warehouse from a random national sample of 652 patients. Radiographic fatty liver disease was determined by manual review by two physicians and verified with an expert radiologist.
Transvaginalultrasound was performed using a 6.5-8 mHz probe and our data confirm that this threshold level for FNPO is still valid if using such probe frequencies, although the use of devices with a maximum frequency lower than 8 mHz has become obsolete. Obviously, newer ultrasound scanner using higher transducer frequency will facilitate the detection of more follicles AbstractText ...
... not routinely been screened for adrenal lesions AbstractText: The frequency, characteristics, and progression of adrenal lesions in patients with polyposis who underwent abdominalimaging were assessed... 3 syndromes AbstractText: The study was limited by its retrospective design AbstractText: Adrenal lesions are frequent in patients with polyposis who undergo abdominalimaging.
The jejunal extension tube was inserted at the first attempt in 15 patients (88.2 %) and 2 required another pyloric intubation. AbdominalX-ray showed that all PEGJ tubes were successfully seated in the proximal jejunum. The mean (SD) time required for jejunal extension insertion was 16.9 (8.6) minutes. Two adverse events occurred due to PEG insertion although none were related ...
The primary-outcome was a reduction in liver fat content, measured by abdominal-ultrasound, and secondary-outcomes were improvement of fibrosis, measured by shear-wave elastography, metabolic and inflammatory parameters, anthropometrics and quality of life (QOL. Fecal samples were collected and analyzed for microbial composition AbstractText: One-hundred patients (60% women, mean age of 41.9±9.8 years and BMI of ...
Anti-Obesity and Weight Loss (2) Fibrosis (2), Alcoholic Fatty Liver (1), Obesity (1), more mentions
Changes in SAT and VAT levels (determined by abdominalMRI), insulin sensitivity (according to the Matsuda Index), and β-cell function (β-index) were assessed during a multiple-sampling oral glucose tolerance test; and circulating levels of IGF-I and IGF-II were assessed before and after a comparable weight ...
Anti-Obesity and Weight Loss (11), Endocrine Disorders (4) Diabetes Mellitus, Type 2 (4), Prediabetic State (3), Obesity (1), more mentions