Sonographic Image of Solitary Kidney in Wilms Tumour Survivors

Background/Aims: This study presents an analysis of the sonographic and laboratory parameters of solitary kidney in Wilms tumour survivors (TWs) and compares these parameters with those of healthy individuals. Methods: Fifty-three TWs who completed treatment for Wilms tumour and 44 healthy individuals were enrolled. The study protocol consisted of completing a medical history, sonographic examination of the solitary kidney, estimation of glomerular filtration rate (eGFR) by the Schwartz or MDRD formulas, albumin urine excretion and BP measurement. Results: Sonographic signs of kidney damage were observed in 22 (41,5%) TWs. The most frequently detected abnormalities are hyperechoic rings around renal pyramids (28,3% TWs). Hypertrophy of the solitary kidney occurred in 71,7% of cases. The mean volume of the solitary kidney was 77% of the sum of the two kidney volumes in the control group. The median eGFR in the TWs group was 117 with 25Q-105,5, 75Q-130 ml/min/1,73 m2 vs 131,8 with 25Q-124, 75Q-140 ml/min/1,73 m2 in the control group (p=0,000). Six TWs (11,3%) had a value of eGFR below 90 ml/min/1,73 m2. Increased urine albumin excretion (> 30 mg/g) was observed in 7 TWs (13,2%) and in 3 (6,8%) individuals in the control group. Conclusion: Ultrasonographic abnormalities in solitary kidney of TWs are frequent. The most frequently detected abnormalities are hyperechoic rings around renal pyramids. Sonographic examination of TWs ought to be performed not only to detect tumour recurrence but also to assess the signs of kidney damage and their progression

The Use of Handheld Ultrasound Devices-An EFSUMB Position Paper

Publisher Copyright: © 2018 Georg Thieme Verlag KG Stuttgart New York.The miniaturization of ultrasound equipment in the form of tablet-or smartphone-sized ultrasound equipment is a result of the rapid evolution of technology and handheld ultrasound devices (HHUSD). This position paper of the European Federation of Societies in Ultrasound and Medicine (EFSUMB) assesses the current status of HHUSD in abdominal ultrasound, pediatric ultrasound, targeted echocardiography and heart ultrasound, and we will report position comments on the most common clinical applications. Also included is a SWOT (Strength-Weaknesses-Opportunities-Threats) analysis, the use for handheld devices for medical students, educational & training aspects, documentation, storage and safety considerations.Peer reviewe

The prevalence of incidentaloma - asymptomatic thyroid nodules in the Tricity (Gdansk, Sopot, Gdynia) population

Introduction: The increased sensitivity of imaging devices raised number of incidentally discovered lesions in various organs of the human body. Thyroid gland is one of them. Reported prevalence of ultrasonographically detected thyroid nodules (incidentalomas) in general population ranges from 5.2 to 67.0%. Our study demonstrated occurrence of this clinical problem in the general population of the Tricity. Material and methods: 135 healthy adults (95 women and 40 men) were examined. Neck palpation, ultrasonographic examinations of thyroid gland and serum tyreotropin (TSH) level measurement were made. Results: In 8.9% of examine (12/135) persons nodules were palpable whereas in 14.8% (20/135) they were detectable only in ultrasonographic examination. Altogether thyroid ultrasound and palpation revealed nodules in 23.7% (32/135) of all cases. Multiple nodules were present in 12.0% of the cases. The pathology was more common in the elderly and in women. TSH serum level was within normal range in all cases of incidentaloma with otherwise normal thyroid gland. Conclusions: Prevalence of thyroid gland nodules (palpation - 8.9% plus ultrasonography - 14.8%) in healthy population of Gdansk, Gdynia and Sopot is close to data reported in southern Finland (27.0%) and Belgium (19.0%), where iodine deficiency is small, like in the Tricity area. The revealed lesions were over two times more frequent in the female population. Most of the nodules were not palpable.Wstęp: Czułość radiologicznych metod obrazowania ma wpływ na częstość rozpoznawania przypadkowych, niemych klinicznie zmian ogniskowych w różnych narządach człowieka, w tym także w gruczole tarczowym. Częstość incydentalnych guzków tarczycy wykrytych ultrasonograficznie waha się, w różnych populacjach, w granicach 5,2–67,0%. W niniejszej pracy przedstawiono ten problem na przykładzie populacji mieszkańców Trójmiasta (Gdańsk, Sopot, Gdynia). Materiał i metody: W badaniu uczestniczyło 135 zdrowych osób (95 kobiet i 40 mężczyzn). U każdego biorącego udział w badaniu pacjenta wykonano badanie przedmiotowe szyi, ultrasonografię (USG) gruczołu tarczowego oraz zmierzono stężenie hormonu tyreotropowego (TSH, thyroid-stimulating hormone) w surowicy. Wyniki: U 8,9% wszystkich uczestników badania (12/135) palpacyjnie stwierdzono guzki tarczycy. Natomiast wyłącznie ultrasonograficzne występowanie zmian ogniskowych tarczycy stwierdzono u dalszych 14,8% badanych osób (20/135). Zatem łącznie zmiany palpacyjne i wykryte w USG stwierdzono u 23,7% (32/135) badanych. Mnogie guzki w badaniu USG wykryto w 12,0% przypadków. Zmiany te były częstsze u kobiet i osób starszych. Stężenie TSH nie wykazywało istotnych korelacji z prawdopodobieństwem występowania guzka incydentalnego. Wnioski: Częstość występowania guzków tarczycy (w badaniu palpacyjnym - 8,9% po dodatkowym wykonaniu badania ultrasonograficznego - 14,8%) w populacji zdrowych mieszkańców Trójmiasta jest zbliżona do wyników uzyskanych w południowej Finlandii (27,0%) i Belgii (19,0%), gdzie niedobór jodu w środowisku jest mały, podobnie jak na Pomorzu. Incydentalne guzki tarczycy prawie 2-krotnie częściej występowały u kobiet niż u mężczyzn. Większość zmian ogniskowych tarczycy odkrytych ultrasonograficznie nie była wyczuwalna w badaniu palpacyjnym

Glomerular filtration rate and prevalence of chronic kidney disease in Wilms’ tumour survivors

Glomerular filtration rate (GFR) was evaluated in 32 Wilms’ tumour survivors (WTs) in a cross-sectional study using 99 Tc-diethylene triamine pentaacetic acid (99 Tc-DTPA) clearance, the Schwartz formula, the new Schwartz equation for chronic kidney disease (CKD), cystatin C serum concentration and the Filler formula. Kidney damage was established by beta-2-microglobulin (B-2-M) and albumin urine excretion, urine sediment and ultrasound examination. Blood pressure was measured. No differences were found between the mean GFR in 99 Tc-DTPA and the new Schwartz equation for CKD (91.8 ± 11.3 vs. 94.3 ± 10.2 ml/min/1.73 m2 [p = 0.55] respectively). No differences were observed between estimated glomerular filtration rate (eGFR) using the Schwartz formula and the Filler formula either (122.3 ± 19.9 vs. 129.8 ± 23.9 ml/min/1.73 m2 [p = 0.28] respectively). Increased urine albumin and B-2-M excretion, which are signs of kidney damage, were found in 7 (22%) and 3 (9.4%) WTs respectively. Ultrasound signs of kidney damage were found in 14 patients (43%). Five patients (15.6%) had more than one sign of kidney damage. Eighteen individuals (56.25%) had CKD stage I (10 with signs of kidney damage; 8 without). Fourteen individuals (43.75%) had CKD stage II (6 with signs of kidney damage; 8 without). The new Schwartz equation for CKD better estimated GFR in comparison to the Schwartz formula and the Filler formula. Furthermore, the WT survivors had signs of kidney damage despite the fact that GFR was not decreased below 90 ml/min/1.73 m2 with 99 Tc- DTPA