Usefulness of 3D transperineal ultrasound in severe stenosis of the anal canal : preliminary experience in four cases

Background Organic or functional anal canal stenoses are uncommon conditions that occur in the majority of cases as a consequence of anal diseases. A proper assessment is fundamental for decision making; however, proctological examination and endoanal ultrasound are often unfeasible or very difficult to perform even under local or general anesthesia. We therefore began to use 3D transperineal ultrasound to assess patients. The aim of this study was to compare the results of evacuation proctography and 3D transperineal ultrasound in patients with severe anal canal stenosis. Methods Four consecutive patients with high-grade anal canal stenosis were evaluated using both proctography and 3D transperineal ultrasound with a micro-convex transducer between March and June 2011.Results In all cases, 3D transperineal ultrasound provided detailed information on the length and level of stenosis and on the integrity of the anal sphincters. Conclusions Our preliminary experience suggests that 3D transperineal ultrasound makes it possible to plan optimal surgical treatment

Degeneration of the symphysis pubis presenting as a submucosal urinary bladder tumour

Urinary bladder sonography is a sensitive diagnostic technique used for visualizing urinary bladder tumours. The aim of our communication is to present a case of a pseudotumour of the urinary bladder originating from the symphysis pubis syndesmosis. A 58-year-old woman was seen by a urologist with symptoms of lower urinary tract infection. Urinary bladder sonography was performed, followed by magnetic resonance imaging. Sonographic images of the bladder showed an exophytic mass on the urinary bladder's anterior wall. A transurethral resection of the tumour was performed. A histopathological examination revealed a necrotic extramural mass, without traits of malignancy. The mass reappeared in the follow-up vesical sonography. Subsequently, its transurethral resection was repeated with the same histopathological findings. The next urinary bladder sonography revealed the presence of the mass again. Pelvic magnetic resonance imaging was performed, which showed advanced degenerative changes in the pubic symphysis syndesmosis that protruded into the bladder, imitating a urinary bladder tumour. To avoid unnecessary surgery, both radiologists and urologists should be made aware that there is a possibility of similar cases in patients. Magnetic resonance imaging enabled correct determination of the primary site of the growth, which, together with the histopathological examination results, influenced the choice of the implemented therapeutic procedures

Common incidental findings on sacroiliac joint MRI in children clinically suspected of juvenile spondyloarthritis

PURPOSE: To determine the prevalence of incidental findings on sacroiliac (SI) joint MRI in children clinically suspected of Juvenile Spondyloarthritis (JSpA). METHODS: In this retrospective multi-center study of 540 children clinically suspected of JSpA who underwent MRI of SI joints from February 2012 to May 2018, the prevalence of sacroiliitis and other incidental findings was recorded. RESULTS: In 106/540 (20 %) children MRI features of sacroiliitis were present. In 228 (42 %) patients MRI showed at least one incidental finding other than sacroiliitis. A total of 271 abnormal findings were reported. The most frequent incidental findings were at lumbosacral spine (158 patients, 29 %) and hip (43 patients, 8 %). The most common incidental finding was axial degenerative changes, seen in 94 patients (17 %). Other less frequent pathologies were: simple (bone) cyst in 15 (2,8 %) patients; enthesitis/tendinitis in 16 (3 %) patients; non-specific focal bone marrow edema (BME) away from SI joints in 10 (1,9 %) patients; ovarian cysts in 7 (1,3 %) patients; BME in the course of chronic recurrent multifocal osteomyelitis (CRMO) in 4 (0,7 %) patients; muscle pathology in 4 (0,7%) patients; benign tumors in 3 (0,6 %) patients; (old) fractures in 3 (0,6 %) patients; bony apophyseal avulsion in 2 (0,4 %) patients and malignant tumors in 2 (0,4 %) patients. CONCLUSION: Incidental findings are common on MRI of the SI joints in children clinically suspected of JSpA, particularly at the lumbar spine and hips. They are seen even more frequently than sacroiliitis and can be relevant, as some will have clinical significance or require treatment

Imaging assessment of children presenting with suspected or known juvenile idiopathic arthritis : ESSR-ESPR points to consider

Juvenile idiopathic arthritis (JIA) is the most common paediatric rheumatic disease. It represents a group of heterogenous inflammatory disorders with unknown origin and is a diagnosis of exclusion in which imaging plays an important role. JIA is defined as arthritis of one or more joints that begins before the age of 16 years, persists for more than 6 weeks and is of unknown aetiology and pathophysiology. The clinical goal is early suppression of inflammation to prevent irreversible joint damage which has shifted the emphasis from detecting established joint damage to proactively detecting inflammatory change. This drives the need for imaging techniques that are more sensitive than conventional radiography in the evaluation of inflammatory processes as well as early osteochondral change. Physical examination has limited reliability, even if performed by an experienced clinician, emphasising the importance of imaging to aid in clinical decision-making. On behalf of the European Society of Musculoskeletal Radiology (ESSR) arthritis subcommittee and the European Society of Paediatric Radiology (ESPR) musculoskeletal imaging taskforce, based on literature review and/or expert opinion, we discuss paediatric-specific imaging characteristics of the most commonly involved, in literature best documented and clinically important joints in JIA, namely the temporomandibular joints (TMJs), spine, sacroiliac (SI) joints, wrists, hips and knees, followed by a clinically applicable point to consider for each joint. We will also touch upon controversies in the current literature that remain to be resolved with ongoing research

Determining thermal comfort conditions in rooms with the PMV and PPD indices

Komfort termiczny jest, obok m.in. jakości powietrza wewnętrznego, poziomu hałasu, czy np. wystroju wnętrza, istotnym elementem pozytywnego odbioru otaczającego środowiska. Z uwagi na stale wydłużający się czas spędzany, zarówno w życiu zawodowym, jak i pozazawodowym w pomieszczeniach, w których warunki środowiska są sztucznie kształtowane przez urządzenia klimatyzacyjne, niezbędne jest zaprojektowanie parametrów powietrza wewnętrznego w taki sposób, aby przebywanie w nich nie prowadziło do zaburzeń zdrowotnych (np. zespół chorego budynku - Sick Building Syndrome). W artykule przedstawiono metodę oceny pomieszczeń pod względem komfortu cieplnego, na podstawie normy PN-EN ISO 7730:2006: Ergonomia środowiska termicznego. Analityczne wyznaczanie i interpretacja komfortu termicznego z zastosowaniem obliczania wskaźników PMV i PPD oraz kryteriów lokalnego komfortu termicznego. W sposób praktyczny zilustrowano prowadzenie takiej oceny na przykładzie pomieszczenia biurowego.Thermal comfort is in addition to, i.a., indoor air quality, noise level, and interior design, an essential element determining the way the surrounding environment is perceived. In light of the fact that time spent both professionally and privately in buildings in which environment conditions are shaped by air conditioning is increasingly longer, it is imperative to design such indoor air parameters which will help to prevent potential health problems (e.g. the Sick Building Syndrome). This paper presents assessment methods of buildings thermal comfort in compliance with the PN-EN ISO 7730:2006 standard "Ergonomics of the thermal environment. Analytical determination and interpretation of thermal comfort using calculation of the PMV and PPD indices and local thermal comfort criteria". A sample office space illustrates how such an assessment can be made

Thermal comfort of surgeons in the operating theatre

W artykule scharakteryzowano warunki mikroklimatu panującego na bloku operacyjnym oraz wymagania dotyczące odzieży medycznej i chirurgicznej. Przedstawiono również wyniki badań przeprowadzonych w ramach I etapu projektu pn. "Ocena właściwości fizjologicznych odzieży chirurgicznej w celu zapewnienia komfortu termicznego", realizowanego w CIOP-PIB.This paper presents a microclimate typical for an operating theatre and the requirements towards medical and surgical clothing. The results of the study conducted within the framework of the 1st phase of the project "Evaluation of physiological characteristics of surgical clothing in order to ensure thermal comfort" implemented in CIOP-PIB are also presented

Thermal comfort in office areas in the aspect of standards

Zapewnienie pracownikom poczucia komfortu cieplnego poprzez regulację odpowiednich parametrów środowiska pracy przekłada się, m.in. na zmniejszenie liczby popełnianych błędów, ograniczenie liczby wypadków oraz chorób zawodowych, a także poprawę wydajności pracy oraz jakości produktów i usług. Dokument przygotowany przez Centrum Tematyczne Research on Work and Health Europejskiej Agencji ds. Bezpieczeństwa i Zdrowia w Pracy wykazał, że dyskomfort termiczny jest identyfikowany jako jeden z głównych fizycznych czynników ryzyka w środowisku pracy. W 2005 roku w warunkach mikroklimatu gorącego zatrudnionych było 17,4 tys., zimnego - 18,3 tys. pracowników w Polsce. W tym artykule przedstawiono możliwości analizy środowiska pracy pod względem komfortu termicznego, na podstawie norm: PN-78/B-03421, PN-ISO 7730:2006(U), prEN 15251. Zwrócono przede wszystkim uwagę na ich aspekt praktyczny, tzn. możliwość projektowania budynków i pomieszczeń spełniających wymagania komfortu cieplnego oraz ocenę komfortu termicznego pomieszczeń.Ensuring employees' thermal comfort by means of regulating and controlling relevant environment parameters means, inter alia, a decrease in the number of mistakes, accidents, and an increase in productivity and quality of products and services. A document prepared by the Research on Work and Health Topic Centre of the European Occupational Safety and Health Administration has shown that thermal discomfort is a principal physical risk factors in the work environment. In 2005, 17 400 workers were employed in the hot environment, and 18 300 in the cold environment in Poland. Estimation of the thermal load of employees exposed to a hot or a cold environment has been discussed in previous papers published in "Bezpieczeństwo Pracy". This paper presents the possibilities of analysing thermal comfort in the work environment according to standards PN-78/B-03421, PN-ISO 7730:2006(U) and prEN 15251. Practical aspects, i.e., the possibility of designing buildings according to the requirements of thermal comfort and estimation of thermal comfort in rooms are discussed, too

The influence of thermal stress on man's physical performance

Stres termiczny, będący integralnym elementem pracy w wielu sytuacjach życia zawodowego i pozazawodowego, ma istotny wpływ na sprawność i bezpieczeństwo działania człowieka. W artykule przedstawiono procesy fizjologiczne oraz sprawności i funkcje poznawcze, których poziom ulega istotnemu obniżeniu w warunkach stresu termicznego, jak również czynniki indywidualne i środowiskowe mające znaczenie w relacji stres termiczny - sprawność człowieka. Szczególną sytuacją, zwłaszcza w sezonie letnim, narażenia na mikroklimat gorący jest stosowanie kasku ochronnego, np. motocyklowego, który mimo niepodważalnej roli w zakresie ochrony głowy przed urazami mechanicznymi, może mieć niekorzystny wpływ na szereg procesów poznawczych motocyklisty, z uwagi na tworzące się w przestrzeni pod kaskiem gorące środowisko. W artykule omówiono więc także szczególną rolę głowy w procesie wymiany ciepła między człowiekiem i otoczeniem, podkreślając przy tym znaczenie badań nad wpływem różnych elementów odzieży ochronnej, w tym kasków, m.in. systemów ich chłodzenia, na komfort i bezpieczeństwo człowieka w warunkach stresu termicznego.Thermal stress, an integral element of work in both professional and non-professional life, has a vital influence on man's physical performance and safety. This article presents physiological as well as cognitive functions and capacities, which decrease considerably under thermal stress, as well as individual and physiological factors, which play a significant role in the relationship between thermal stress and human performance. The use of a protective helmet (for instance, a motorcycle helmet) brings about exposure to a hot microclimate, especially in summer. Admittedly, its role in protecting the head against mechanical trauma is unquestionable; nonetheless due to the hot microclimate generated in the space under the motorcyclists helmet, it can have a negative influence on a number of cognitive processes. The article also discusses the special role the head plays in the process of heat exchange between man and the environment. It emphasizes the significance of research on the impact of various elements of protective clothing (including helmets) and, e. g., their cooling systems on comfort and safety of man under thermal stress