Digital chest radiography: an update on modern technology, dose containment and control of image quality

The introduction of digital radiography not only has revolutionized communication between radiologists and clinicians, but also has improved image quality and allowed for further reduction of patient exposure. However, digital radiography also poses risks, such as unnoticed increases in patient dose and suboptimum image processing that may lead to suppression of diagnostic information. Advanced processing techniques, such as temporal subtraction, dual-energy subtraction and computer-aided detection (CAD) will play an increasing role in the future and are all targeted to decrease the influence of distracting anatomic background structures and to ease the detection of focal and subtle lesions. This review summarizes the most recent technical developments with regard to new detector techniques, options for dose reduction and optimized image processing. It explains the meaning of the exposure indicator or the dose reference level as tools for the radiologist to control the dose. It also provides an overview over the multitude of studies conducted in recent years to evaluate the options of these new developments to realize the principle of ALARA. The focus of the review is hereby on adult applications, the relationship between dose and image quality and the differences between the various detector systems

Tioconazole in the treatment of vaginal candidosis

A 3-day treatment with tioconazole vaginal tablets (Gyno-Trosid; Pfizer) was used in 30 patients with vaginal candidosis during a prospective, mycologically controlled study. Candida yeasts were identified by microscopy and culture before initiation of treatment and then on days 3, 6 and 28. On the 6th day, all patients had responded to the treatment and there was a 100% cure rate on microscopic and mycological examination. After 4 weeks, 83% of the patients still had relief of symptoms, although a recurrence of Candida on culture and microscopy was detected in 14 patients (46%). Seven of these were available for further assessment and, when given a second course of treatment, they were cured both clinically and microbiologically. There was no evidence of any adverse systemic reaction and local side effects were limited to a transient sensation of mild to moderate burning. Problems relating to recurrence of symptoms and reappearance of Candida are discussed.Articl

Phaeochromocytoma in pregnancy. A case report and review

The diagnosis of phaeochromocytoma is seldom made during pregnancy. A case is presented in which the tumour was diagnosed associated with an 18 wk intrauterine dead fetus. The pre-operative treatment with alpha- and beta-blocking agents, as well as the surgical approach of a phaeochromocytoma accompanied by a fetal death is discussed.Articl