Contrast media for radiological examination in gastrointestinal tract leakage

The aim of this investigation has been to find a safe and suitable contrast medium for radiological evaluation of the gastrointestinal tract in cases where leakage outside the GIT can be suspected. Leakage outside the gastro-intestinal tract lumen can occur in many ways eg., spontaneously, due to a disease process, iatrogenically or postoperatively at the site of anastomosis. The contrast medium used for the radiological evaluation of such patients could leak outside the lumen of the GIT and enter the mediastinum, pleura, peritoneum or bronchi and lungs. It is therefore essential to use a contrast medium, which would be safe should it leak into one or more of the regions mentioned. An experimental study was carried out to evaluate the reactions of various available CM in the bronchi and lungs, mediastinum, pleura and peritoneum of rats. The CM evaluated in the experimental study were, pure barium sulphate (without any additives), commercial barium sulphate (Micropaque, with additives), Dionosil, Hytrast, Gastrografin, Amipaque (in pleura Omnipaque) and Hexabrix. The results of all the experiments taken together show that lower osmolality contrast media Hexabrix, Amipaque and Omnipaque are safer than all other CM examined experimentally, for radiological evaluation of leakage from the GIT. The clinical use of Hexabrix was started ± 4 years ago for the examination of suspected UGIT leakage and has, so far, shown no untoward or negative effects. The aim and introduction in Chapter 1 are followed by various aspects of the contrast media in chapters 2 and 3. Chapter 4 deals with the aetiology of leakage, experimental investigation, clinical experience and method of radiological evaluation of gastrointestinal tract leakage. Chapters 5, 6, 7, 8 and 9 deal comprehensively with the experimental study. The clinical use of Hexabrix in the UGIT is described in chapter 10. The general discussion and conclusions are given in chapter 11

Chronic instability of the foot and foot geometry: A radiographic study

Multiple factors are involved in chronic lateral instability of the ankle. The geometry of the foot may be of importance. A cavovarus foot may predispose to lateral ligament injuries. In the present study, standardized lateral X-rays were obtained of the feet of patients with chronic instability and of a control group. Four parameters were used: (1) the tarsal index as described by Benink; (2) the talocalcaneal angle; (3) the talometatarsal angle; and (4) the calcaneal angle. No relationship between lateral instability of the foot and foot geometry was found. The talocalcaneal angle as defined in this study was found to be a less appropriate parameter in measuring the longitudinal foot arch

Sonography for hip joint effusion in adults with hip pain

OBJECTIVE: To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. METHODS: Patients (n = 224) aged 50 years or older with hip pain, referred by the general practitioner for radiological investigation, underwent a standardised examination. The distance between the ventral capsule and the femoral neck, an increase in which represents joint effusion, was measured sonographically. Joint effusion was defined in three different ways: "effusion" according to Koski's definition, "major effusion", and "asymmetrical effusion" based on only individual side differences. RESULTS: "Effusion" was present in 80 (38%), "major effusion" in 20 (9%), and "asymmetrical effusion" in 47 (22%) patients. Pain in the groin or medial thigh, pain aggravated by lying on the side, decreased extension/internal rotation/abduction/flexion, painful external rotation, and pain on palpation in the groin showed a significant relation (adjusted for age and radiological osteoarthritis of the hip) with ultrasonic hip joint effusion. "Major effusion" showed a significant relation with an increased ESR. When patients with bilateral pain and increased ESR were excluded, a side difference in the range of motion of extension of the hip was shown to be a good predictor for "asymmetrical effusion" (positive predictive value: 71%, negative predictive value: 80%). CONCLUSION: This study showed a relatively high prevalence of ultrasonic joint effusion in adults with hip pain in general practice. Furthermore the results indicate a relation between joint effusion and clinical signs

The relationship between cam morphology and hip and groin symptoms and signs in young male football players

Background: Conflicting and limited high-quality prospective data are available on the associations between cam morphology and hip and groin symptoms and range of motion (ROM). Objectives: This cross-sectional cohort study investigated associations between cam morphology presence, size and duration and symptoms and ROM. Methods: Academy male football players (n = 49, 17-24 years) were included. Standardized antero-posterior pelvic and frog-leg lateral radiographs were obtained at baseline, 2.5- and 5-year follow-up. The femoral head-neck junction was quantified by: Visual score. Cam morphology (flattening or prominence), large cam (prominence). Alpha angle.

Indices from flow-volume curves in relation to cephalometric, ENT- and sleep-O2 saturation variables in snorers with and without obstructive sleep-apnoea

In a group of 37 heavy snorers with obstructive sleep apnoea (OSA, Group 1) and a group of 23 heavy snorers without OSA (Group 2) cephalometric indices, ENT indices related to upper airway collapsibility, and nocturnal O2 desaturation indices were related to variables from maximal expiratory and inspiratory flow-volume (MEFV and MIFV) curves. The cephalometric indices used were the length and diameter of the soft palate (spl and spd), the shortest distance between the mandibular plane and the hyoid bone (mph) and the posterior airway space (pas). Collapsibility of the upper airways was observed at the level of the tongue base and soft palate by fibroscopy during a Muller manoeuvre (mtb and msp) and ranked on a five point scale. Sleep indices measured were the mean number of oxygen desaturations of more than 3% per hour preceded by an apnoea or hypopnoea of more than 10 s (desaturation index), maximal sleep oxygen desaturation, baseline arterial oxygen saturation (Sa,O2) and, in the OSA group, percentage of sleep time with Sa,O2 < 90%. The variables obtained from the flow-volume curves were the forced vital capacity (FVC), forced expiratory and inspiratory volume in 1 s (FEV1 and FIV1), peak expiratory and peak inspiratory flows (PEF and PIF), and maximal flow after expiring 50% of the FVC (MEF50). The mean of the flow-volume variables, influenced by upper airway aperture (PEF, FIV1) was significantly greater than predicted.(ABSTRACT TRUNCATED AT 250 WORDS

Correction to: Clinical and radiological hip parameters do not precede, but develop simultaneously with cam morp

Due to typographic mistakes made by the editorial office, several corrections have been made. The original article has been corrected