BackgroundBecause neither the incidence and risk factors for rhabdomyolysis in the ICU nor the dynamics of its main complication, i.e., rhabdomyolysis-induced acute kidney injury (AKI) are well known, we retrospectively studied a large population of adult ICU patients (n = 1,769).MethodsCK and sMb (serum myoglobin) and uMb (urinary myoglobin) were studied as markers of rhabdomyolysis and AKI (RIFLE criteria). Hemodialysis and mortality were used as outcome variables.ResultsProlonged surgery, trauma, and vascular occlusions are associated with increasing CK values. CK correlates with sMb (p < 0.001) and peaks significantly later than sMb or uMb.The logistic regression showed a positive correlation between CK and the development of AKI, with an OR of 2.21. Univariate logistic regression suggests that elevations of sMb and uMb are associated with the development of AKI, with odds ratios of 7.87 and 1.61 respectively. The ROC curve showed that for all three markers a significant correlation with AKI, for sMb with the greatest area under the curve. The best cutoff values for prediction of AKI were CK > 773 U/l; sMb > 368 μg/l and uMb > 38 μg/l respectively.ConclusionsBecause it also has extrarenal elimination kinetics, our data suggest that measuring myoglobin in patients at risk for rhabdomyolysis in the ICU may be useful.

Mimickers of soft tissue tumours in the hand and wrist are more frequent than true neoplastic lesions. Pseudotumours belong to a large and heterogeneous group of disorders, varying from normal anatomical variants, cystic lesions, post-traumatic lesions, skin lesions, inflammatory and infectious lesions, non-neoplastic vascular lesions, metabolic disorders (crystal deposition disease and amyloidosis) and miscellaneous disorders. Although the imaging approach to pseudotumoural lesions is often very similar to the approach to “true” soft tissue tumoral counterparts, further management of these lesions is different. Biopsy should be performed only in doubtful cases, when the diagnosis is unclear. Therefore, the radiologist plays a pivotal role in the diagnosis of these lesions. Awareness of the normal anatomy and existence and common imaging presentation of these diseases, in combination with relevant clinical findings (clinical history, age, location and skin changes), enables the radiologist to make the correct diagnosis in most cases, thereby limiting the need for invasive procedures.

noonan syndrome (ns) is an etiologically heterogeneous disorder caused by mutations in the ras-maPK signaling pathway. noonan-like/multiple giant Cell lesion (nl/mgCl) syndrome is initially described as the occurrence of multiple gnathic giant cell lesions in patients with phenotypic features of ns. nowadays, ns/mgCl syndrome is considered a variant of the ns spectrum rather than a distinct entity. we report the case of a 14-year-old female patient carrying a SOS1 mutation with a unilateral giant cell lesion of the right mandible. Cross-sectional imaging such as Ct and mri are not specific for the diagnosis of oral giant cell lesions. nonetheless, intralesional scattered foci of low si on t2-wi, corresponding to hemosiderin deposits due to hemorrhage, can help the radiologist in narrowing down the differential diagnosis of gnathic lesions in patients with ns. Key-word: jaws.From: 1.

A previously well 31-year-old woman who had given birth to a healthy baby eleven days previously, presented with a undulating fever and nausea that started immediately in the postpartal period after an uncomplicated vaginal delivery. Clinical examination revealed an elective tenderness in the right fossa without rebound tenderness. Rovsing's sign, Murphy's sign, Murphy's punch sign and the psoas sign were all negative.

Background:A 41-year-old woman without a relevant history was admitted to the emergency department after an epileptic seizure.

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Background: A 55-year-old man without relevant medical history was admitted to the emergency department with painful abdominal cramps, vomiting, nausea, and absence of flatus. There was no altered bowel habit in the last months, no melena and no red blood loss per anum. Physical examination was normal except for lower abdominal tenderness and reduced bowel sounds. Laboratory findings were unremarkable. Conventional radiography of the abdomen was made, followed by MultiDetector Computed Tomography (MDCT) scan of the abdomen.