599 research outputs found

    The ultrasonographic differentiation of obstructive vs. nonobstructive hydronephrosis in children

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    Current Management of Urinary Tract Infection in Children

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    Pediatric urinary tract infection: imaging techniques with special reference to voiding cystoerethrography

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    Urinary tract infection (UTI) is the second most common infection in childhood. Large hospital-based pediatric series report an incidence of 3-5%. Dickinson prospectively determined that 1.7/1000 boys and 3.1/1 000 girls annually present with a UTI. This corresponds to about 780 girls and 430 boys per million population aged 0-14 years. Under age 6 years, a UTI furthermore is an indicator of an anatomic and/or functional urinary tract disorder in 35-50% of these patients. Vesicoureteral reflux (VUR) is present in 30-35% of these, but is present in 85% of children with evidence of renal scarring.4•5 This scarring, in turn, is responsible for 20-40% of end-stage renal failure in patients under 40 years of age. From these figures it can be estimated that the risk for hypertension or renal failure after a first, laboratory and clinically proven (index) UTI is about 1% for boys and 0.5% for girls. The imaging evaluation of these children has a dual purpose. On the one hand, it is intended to establish that the kidneys, bladder and urethra are normal, so that subsequent UTis can be treated by a 10 day course of antibiotics without risking renal damage. This affords the opportunity to make sure that normal kidneys remain normal. On the other hand, appropriate imaging is intended to a) identify and grade the severity of VUR, b) to define the extent of renal scarring and to c) determine the site of obstruction, if any. This allows for minimizing renal damage.8 Early identification of these abnormalities, the anatomic basis of which will be discussed later, thus offers the prospect of preventive medicine and sound advice to the clinician regarding antibiotic (for lower grades of VUR) or surgical (for higher grades of VUR and obstructive etiologies) therapeutic measures. The available imaging modalities (VCUG, EU, US, Urodynamics and Radionuclides) all have different capabilities and limitations and should not be used indiscriminately as some employ ionizing radiation, others are invasive, uncomfortable and expensive

    Focal Spot, Summer/Fall 2007

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    https://digitalcommons.wustl.edu/focal_spot_archives/1106/thumbnail.jp

    Minimally Invasive Urological Procedures and Related Technological Developments

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    The landscape of minimally invasive urological intervention is changing. A lot of new innovations and technological developments have happened over the last 3 decades. Laparoscopy and robotic surgery have revolutionised kidney and prostate cancer treatment, with more minimally invasive procedures now being carried out than ever before. At the same time, technological advancements and the use of laser have changed the face of endourology. Several new innovative treatments are now commonplace for benign prostate enlargement (BPE). Management of prostate cancer now involves procedures such as robotic prostatectomy, brachytherapy, radiotherapy, cryotherapy and HIFU. Robotic partial nephrectomy and cryotherapy have changed the face of renal cancer. En-bloc resection of bladder cancer is challenging the traditional management of non-muscle invasive bladder cancer and becoming commonplace, while robotic cystectomy is also gaining popularity for muscle invasive bladder cancer. Newer surgical intervention related to BPE includes laser (holmium, thulium and green light), water-based treatment (Rezum, Aquablation) and other minimally invasive procedures such as prostate artery embolisation (PAE) and Urolift. Endourological procedures have incorporated newer laser types and settings such as moses technology, disposable ureteroscopes (URS) and minimisation of percutaneous nephrolithotomy (PCNL) instruments. All these technological innovations and improvements have led to shorter hospital stay, reduced cost, potential reduction in complications and improvement in the quality of life (QoL)

    Diffusion-weighted magnetic resonance imaging in diagnosing graft dysfunction : a non-invasive alternative to renal biopsy.

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    The thesis is divided into three parts. The first part focuses on background information including how the kidney functions, diseases, and available kidney disease treatment strategies. In addition, the thesis provides information on imaging instruments and how they can be used to diagnose renal graft dysfunction. The second part focuses on elucidating the parameters linked with highly accurate diagnosis of rejection. Four parameters categories were tested: clinical biomarkers alone, individual mean apparent diffusion coefficient (ADC) at 11-different b- values, mean ADCs of certain groups of b-value, and fusion of clinical biomarkers and all b-values. The most accurate model was found to be when the b-value of b=100 s/mm2 and b=700 s/mm2 were fused. The third part of this thesis focuses on a study that uses Diffusion-Weighted MRI to diagnose and differentiate two types of renal rejection. The system was found to correctly differentiate the two types of rejection with a 98% accuracy. The last part of this thesis concludes the work that has been done and states the possible trends and future avenues

    The renal parenchyma – evaluation of a novel ultrasound measurement to assess fetal renal development

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    Sonja Brennan used a novel ultrasound measurement of the renal parenchyma to evaluate fetal kidney growth. Normal ranges of fetal renal parenchymal thickness were developed to aid diagnosis of kidney disease and help predict future kidney function. The effects of abnormal fetal growth and diabetes on the developing kidneys was explored

    Diseases of the Abdomen and Pelvis 2018-2021: Diagnostic Imaging - IDKD Book

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    Gastrointestinal disease; PET/CT; Radiology; X-ray; IDKD; Davo
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