ObjectiveTo assess the reliability and reproducibility of abdominal ultrasonography (US) for measuring the postvoid residual urine volume (PVR), and to compare measurements by a radiologist and urologist, in men with lower urinary tract symptoms (LUTS), as a significant PVR is common in patients with LUTS and an assessment of the PVR could protect patients from unnecessary catheterisation.Patients and methodsThis was a prospective comparative study of 45 men aged ⩾45 years with LUTS attending a urological outpatient clinic from July 2011 to May 2012. A detailed history was taken, with an assessment of LUTS using the Arabic Validated International Prostate Symptom Score (IPSS) and complete general and local examination. The PVR was measured by US twice by a radiologist and urologist, and then repeated after 1 week. Within ⩽2 min after US a urethral catheter was used to measure the PVR.ResultsThe mean (range) age of the patients was 63.8 (45–88) years and the mean IPSS was 16.18. Reliability testing between the PVR measured by US and the catheterised measure of PVR showed that US was not reliable (Cronbach’s α < 0.7). The US measurement was reproducible for both single examiner over two sessions, and with two examiners in one session. The PVR obtained by the urethral catheter was significantly higher than the US measurement (P < 0.05).ConclusionsThe measurement of PVR by US is reproducible by either a urologist or radiologist, but it is not reliable, as the urethral catheter estimate gives a significantly higher PVR.
Background Since the announcement of COVID-19 as a pandemic infection, several studies have been performed to discuss the clinical picture, laboratory finding, and imaging features of this disease. The aim of this study is to demarcate the imaging features of novel coronavirus infected pneumonia (NCIP) in different age groups and outline the relation between radiological aspect, including CT severity, and clinical aspect, including age, oxygen saturation, and fatal outcome. We implemented a prospective observational study enrolled 299 laboratory-confirmed COVID-19 patients (169 males and 130 females; age range = 2–91 years; mean age = 38.4 ± 17.2). All patients were submitted to chest CT with multi-planar reconstruction. The imaging features of NCIP in different age groups were described. The relations between CT severity and age, oxygen saturation, and fatal outcome were evaluated. Results The most predominant CT features were bilateral (75.4%), posterior (66.3%), pleural-based (93.5%), lower lobe involvement (89.8%), and ground-glass opacity (94.7%). ROC curve analysis revealed that the optimal cutoff age that was highly exposed to moderate and severe stages of NCIP was 38 years old (AUC = 0.77, p < 0.001). NCIP was noted in 42.6% below 40-year-old age group compared to 84% above 40-year-old age group. The CT severity was significantly related to age and fatal outcome (p < 0.001). Anterior, centrilobular, hilar, apical, and middle lobe involvements had a significant relation to below 90% oxygen saturation. A significant negative correlation was found between CT severity and oxygen saturation (r = − 0.49, p < 0.001). Crazy-paving pattern, anterior aspect, hilar, centrilobular involvement, and moderate and severe stages had a statistically significant relation to higher mortality. Conclusion The current study confirmed the value of CT as a prognostic predictor in NCIP through demonstration of the strong relation between CT severity and age, oxygen saturation, and the fatal outcome. In the era of COVID-19 pandemic, this study is considered to be an extension to other studies discussing chest CT features of COVID-19 in different age groups with demarcation of the relation of chest CT severity to different pattern and distribution of NCIP, age, oxygen saturation, and mortality rate.
BackgroundOsteoporosis and related fragility fractures are one of the most common complications seen in patients with rheumatoid arthritis (RA). Increased osteoclast activity contributes to local and systemic abnormalities of bone remodelling, including bone erosions and focal and systemic osteoporosis. Receptor Activator of Nuclear Factor Kappa Beta Ligand (RANKL) is essential for osteoclast formation, function, and survival, and it is a key mediator of increased osteoclast activity in RA. As fracture prevention is the major target in prevention and diagnosis of osteoporosis, we are evaluating fracture risk in RA patients using the fracture risk assessment (FRAX) tool developed by the WHO. Moreover, we are searching for a potential association between serum RANKL and fracture risk aiming at identifying patients at high risk of fractures.ObjectivesTo assess the level of serum RANKL in post-menopausal rheumatoid arthritis patients and its correlation with fracture risk using Fracture Risk Assessment Tool (FRAX).MethodsWe recruited 116 individuals (78 postmenopausal RA patients and 38 age-matched post-menopausal control subjects). All patients and controls were not receiving osteoporosis treatment. We measured serum RANKL, C reactive protein (CRP) and Rheumatoid Factor (RF). Disease activity score (DAS)-28 was used to assess RA activity. We measured bone mineral density (BMD) at lumbar spine (L1- L4), right femur neck and right forearm radius with dual-energy X-ray absorptiometry. We have calculated the absolute 10-year major osteoporotic fracture and hip fracture risks with FRAX tool.ResultsMean age was 54.83± 6.6 years in RA patients versus 55.05± 6.2 years in controls. Mean body mass index (BMI) of the patients was 30± 5.6. Mean disease duration was 10.53± 6.6 years. Mean DAS was 3.94± 1.3, mean CRP level was 8± 5.2 mg/L and 76.9% of patients were on steroids. Two of the patients were smokers and no one was taking alcohol. One of the patients reported history of fragility fracture at the forearm but no one reported parent hip fracture. Serum RANKL was significantly higher in RA patients versus controls (971.0pmol/L vs. 177.85 pmol/L, P value <0.0001). Mean BMD of RA patients at lumbar spine was 0.990± 0.2 g/cm2, at femur neck was 0.870±0.19 g/cm2 and at forearm was 0.568± 0.14 g/cm2. Prevalence of osteoporosis in RA patients at lumbar spine was 34.6%, at femur neck was 23.1% and at forearm was 42.3%. Risk of major osteoporotic fracture in RA patients was 8.62% and the risk of hip fracture was 3.3%. There was a highly significant positive correlation between serum RANKL and the risk of major osteoporotic fracture (r =0.736, P value<0.0001). There was a highly significant positive correlation between serum RANKL and the risk of hip fracture (r =0. 859, P value <0.0001). Serum RANKL was negatively correlated with femur neck BMD (r= -0.529, P value <0.001) and negatively correlated with forearm BMD (r= -0.289, P value <0.01). No significant correlation was found between serum RANKL and BMD at lumbar spine, RF, CRP le...
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