Background
To evaluate how far is selective renal artery embolization (RAE) using permanent agents effective in treating acute renal artery bleeding. We retrospectively reviewed the medical records of patients (n = 45) with renal bleeding who were managed by selective RAE using coils, N-butyl-cyanoacrylate glue (NBCA glue), and polyvinyl alcohol (PVA). Data retrieved included the cause, number, and type of the bleeding lesions as well as the results of the embolization for 1 year after RAE. Clinical success was the primary outcome while re-bleeding and complications were the secondary outcomes.
Results
There were 55 bleeding lesions detected by angiography in the included 45 patients. Coils were used in 23/45 patients (51.1%), NBCA glue in 15/45 patients (33.3%), and PVA in 7 patients (15.6%). Bleeding could be controlled with embolization in a single session in 41/45 patients with primary clinical success 91.1%. Four patients needed re-embolization sessions to control bleeding and only one patient was controlled, giving secondary clinical success of 92.3%. Three patients failed to respond to embolization and nephrectomy was done. Iatrogenic dissection of the segmental branch was seen in one patient. Post embolization syndrome was seen in 14/45 patients (31.1%). Non-target embolization was seen in 2 patients: one during treatment with NBCA glue and the other with PVA. No other complications were recorded. No significant differences between clinical success among coil, NBCA glue, and PVA subgroups (P > 0.05).
Conclusion
Selective RAE using permanent agents is effective in controlling renal bleeding and no significant difference among coil, NBCA glue, and PVA.
Ovotesticular difference of sex development (OT DSD) is a rare genetic disorder with an incidence of about 1/100,000 live births. The majority of OT DSD patients show a 46,XX karyotype, others may have 46,XX/46,XY chimerism or exhibit various mosaic sex chromosome combinations, and less commonly they may have a 46,XY karyotype. The aim of this work is to report the clinical, pathological, and karyotypic variations in OT DSD patients diagnosed among a large cohort of DSD patients. The study included 10 patients thoroughly evaluated for clinical, genital, and hormonal abnormalities and subjected to imaging studies, laparoscopy with gonadal biopsy, karyotype, and FISH analysis. The current study revealed a greater percentage of mosaic cell line combinations than previously reported and showed variable cytogenetic abnormalities, including the rare isodicentric (Y)(p11.32) abnormality and X;Y translocation. The study also revealed a unique pattern of gonadal type and combination frequencies. To our knowledge, this is the first study on OT DSD patients among a large cohort of DSD patients in Egypt and the Middle East.
Zusammenfassung
Ziel
Evaluation teleradiologischer Untersuchungen bezüglich der häufigsten Anforderungszeiten, der Häufigkeit angefragter Untersuchungen und klinischer Fragestellungen sowie zusätzlicher Auswertung der Pathologiefrequenz, gegliedert nach Organregionen und Fragestellungen.
Material und Methoden
Retrospektive Analyse der klinischen Angaben, Fragestellungen, untersuchten Organregionen und Diagnosen aller konsekutiven teleradiologischen Computertomographie(CT)-Untersuchungen eines Schwerpunktversorgers aus dem Jahr 2018, der 3 Kliniken der Basis- und Grundversorgung teleradiologisch betreut. Subgruppenanalysen häufiger klinischer Angaben und Befunde nach Organregionen und eine zusätzliche Auswertung des Untersuchungszeitpunktes (Datum und Tageszeit) wurden durchgeführt.
Ergebnisse
Es wurden 1207 Fälle aus der teleradiologischen Befundung eingeschlossen. Am häufigsten wurden CT-Untersuchungen des Schädels mit 77,9 % (davon 14,6 % mit Pathologie) durchgeführt, gefolgt von Abdomen mit 14 % (63,9 % pathologisch), Wirbelsäule/Extremitäten mit 8,8 % (50 % pathologisch) und des Thorax mit 7,9 % (53,7 % pathologisch). Die meisten Anforderungen wurden am Wochenende zwischen 8 und 16 Uhr, gefolgt von 16 bis 18 Uhr an Werktagen gestellt. Die geringste Untersuchungsfrequenz lag zwischen 2 und 4 Uhr morgens.
Schlussfolgerung
Teleradiologische CT-Untersuchungen werden vorwiegend zur Abklärung von zerebralen Pathologien durchgeführt, gefolgt von Fragestellungen bezüglich vermuteter Pathologien des Abdomens/Beckens, Skelettsystems und des Thorax. Dabei weist die zerebrale Bildgebung die niedrigste, die Bildgebung von Abdomen/Becken die höchste Pathologie-Inzidenz auf.
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