The offshore Levant Basin demonstrates one of the most phenomenal natural examples of a working petroleum system associated with a relatively rapid unloading and loading cycle caused by the Messinian salinity crisis (MSC). In this study, 2D basin and petroleum systems modelling suggests that the geologically instantaneous water unloading of approximately 2070 m, and subsequent rapid salt deposition and refill, impact the subsurface pore pressure and temperature in the underlying sediments. The pressure drop is modelled to be instantaneous, whereas the impact on temperature is more of a transient response. This has important consequences for the shallow sub-Messinian biogenic petroleum system, which is assumed to have experienced fluid brecciation associated with massive fluid escape events. Deeper Oligo-Miocene sediments are far less affected, thus indicating a ‘preservation window’ for biogenic gas accumulations, which host the recent discoveries (Tamar, Leviathan, Aphrodite). Hydrocarbon accumulations of a ‘bubblepoint oil’ composition are modelled to have experienced cap expansion during the drawdown, with the pressure drop being the primary control. This study suggests that seal-limited traps are expected to have undergone a catastrophic seal failure, whereas the impact of the MSC is modelled to be less destructive for size-limited and, particularly, charge-limited traps.
Objectives: to determine the accuracy of renal point of care ultrasound (POCUS) performed by emergency physicians in detecting hydronephrosis in patients with renal colic. Methods: We conducted a prospective cross-sectional diagnostic study at Sultan Qaboos University Hospital, emergency department (ED), from February 2017 to October 2018. All adult patients with suspected renal colic and who can give informed consent were included. The emergency physicians perform POCUS on both kidneys and graded hydronephrosis as none, mild, moderate, or severe cases. We compared POCUS grade to non-contrast computed tomography (NCCT) grade. Results: Three hundred and three participants were enrolled in the analysis. Most of the study population are adult males, 247 (81.5%), and the mean age is 39 years. Among the samples, 71.2% of patients had a degree of hydronephrosis based on CT findings. Ultrasound performed by emergency physicians had a sensitivity of 75.8% (95% CI: 69.5‒81.4), the specificity of 55.2% (95% CI: 44.1‒65.8), the positive likelihood ratio of 1.69 (95% CI: 1.32‒2.16), and negative likelihood ratio 0.43 (95% CI: 0.32‒0.59) for hydronephrosis using CT as the criterion standard. Conclusions: When evaluating patients with suspected renal colic, a bedside renal POCUS performed by emergency physicians (EP) has a moderate sensitivity to detect hydronephrosis and grade its severity. It should be utilized in the ED to screen patients for hydronephrosis. More training is required to improve the test's accuracy, as this might help as a screening tool in ED.Keywords: Hematuria; Hydronephrosis; Nephrolithiasis; Point-of-care testing; Renal colic; Ultrasonography.
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