Extraperitoneal urine leak after renal transplantation: the role of radionuclide imaging and the value of accompanying SPECT/CT - a case report

<p>Abstract</p> <p>Background</p> <p>The differentiation of the nature of a fluid collection as a complication of kidney transplantation is important for management and treatment planning. Early and delayed radionuclide renography can play an important role in the evaluation of a urine leak. However, it is sometimes limited in the evaluation of the exact location and extent of a urine leak.</p> <p>Case Presentation</p> <p>A 71-year-old male who had sudden anuria, scrotal swelling and elevated creatinine level after cadaveric renal transplantation performed Tc-99 m MAG3 renography to evaluate the renal function, followed by an ultrasound which was unremarkable. An extensive urine leak was evident on the planar images. However, an exact location of the urine leak was unknown. Accompanying SPECT/CT images confirmed a urine leak extending from the lower aspect of the transplant kidney to the floor of the pelvic cavity, presacral region and the scrotum via right inguinal canal as well as to the right abdominal wall.</p> <p>Conclusions</p> <p>Renal scintigraphy is very useful to detect a urine leak after renal transplantation. However, planar imaging is sometimes limited in evaluating the anatomical location and extent of a urine leak accurately. In that case accompanying SPECT/CT images are very helpful and valuable to evaluate the anatomical relationships exactly.</p

Is Evaluation of Hepatitis A Immunity Required or Not?

Hepatitis A virus (HAV) infection is one of the most common causes of acute hepatitis and it is a serious health problem worldwide. HAV infection is a vaccine preventable disease that can produce the lifelong immunity seen in many developed countries with the vaccination schedule administered to children; however this vaccine is not used in developing countries at the present time. Improvements in food and water hygiene have caused a displacement of hepatitis A infection from children to adults which has increased mortality rates. Therefore evaluation of HAV immunity levels can help health authorities develop polices for prophylaxis especially in developing countries

Non-Image-Forming Light Driven Functions Are Preserved in a Mouse Model of Autosomal Dominant Optic Atrophy

Autosomal dominant optic atrophy (ADOA) is a slowly progressive optic neuropathy that has been associated with mutations of the OPA1 gene. In patients, the disease primarily affects the retinal ganglion cells (RGCs) and causes optic nerve atrophy and visual loss. A subset of RGCs are intrinsically photosensitive, express the photopigment melanopsin and drive non-image-forming (NIF) visual functions including light driven circadian and sleep behaviours and the pupil light reflex. Given the RGC pathology in ADOA, disruption of NIF functions might be predicted. Interestingly in ADOA patients the pupil light reflex was preserved, although NIF behavioural outputs were not examined. The B6; C3-Opa1Q285STOP mouse model of ADOA displays optic nerve abnormalities, RGC dendropathy and functional visual disruption. We performed a comprehensive assessment of light driven NIF functions in this mouse model using wheel running activity monitoring, videotracking and pupillometry. Opa1 mutant mice entrained their activity rhythm to the external light/dark cycle, suppressed their activity in response to acute light exposure at night, generated circadian phase shift responses to 480 nm and 525 nm pulses, demonstrated immobility-defined sleep induction following exposure to a brief light pulse at night and exhibited an intensity dependent pupil light reflex. There were no significant differences in any parameter tested relative to wildtype littermate controls. Furthermore, there was no significant difference in the number of melanopsin-expressing RGCs, cell morphology or melanopsin transcript levels between genotypes. Taken together, these findings suggest the preservation of NIF functions in Opa1 mutants. The results provide support to growing evidence that the melanopsin-expressing RGCs are protected in mitochondrial optic neuropathies

The role of leadership in salespeople’s price negotiation behavior

Salespeople assume a key role in defending firms’ price levels in price negotiations with customers. The degree to which salespeople defend prices should critically depend upon their leaders’ influence. However, the influence of leadership on salespeople’s price defense behavior is barely understood, conceptually or empirically. Therefore, building on social learning theory, the authors propose that salespeople might adopt their leaders’ price defense behavior given a transformational leadership style. Furthermore, drawing on the contingency leadership perspective, the authors argue that this adoption fundamentally depends on three variables deduced from the motivation–ability–opportunity (MAO) framework, that is, salespeople’s learning motivation, negotiation efficacy, and perceived customer lenience. Results of a multi-level model using data from 92 salespeople and 264 salesperson–customer interactions confirm these predictions. The first to explore contingencies of salespeople’s adoption of their transformational leaders’ price negotiation behaviors, this study extends marketing theory and provides actionable guidance to practitioners

Malaysian nurses' evaluation of transnational higher education courses

Nirmala Arunasalam, "Malaysian nurses’ evaluation of transnational higher education courses", British Journal of Nursing, Vol. 25 (6): 337-340, March 2016, DOI: https://doi.org/10.12968/bjon.2016.25.6.337The internationalisation of higher education has led some UK and Australian universities to deliver transnational higher education (TNHE) post-registration top-up nursing degree courses in Malaysia. These are bridging courses that allow registered nurses to upgrade their diploma qualifications to degree level. What is not sufficiently explored in the literature is nurses’ evaluation of these courses and the impact of TNHE qualifications. A hermeneutic phenomenology approach was used to explore the views of 18 Malaysian nurses from one Australian and two UK TNHE universities. Semi-structured interviews were conducted to enable the Malaysian nurses to evaluate the courses. Data were analysed by thematic analysis. Findings showed a gap between Malaysian and Western teaching and learning outlook, professional values and clinical practices. The data give important insights at a time when the aim of Malaysia’s investment in TNHE courses is to attain a graduate workforce with changed mind-sets and enhanced patient care.Peer reviewe