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Antineoplastic Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Among these infants, two were normal, one infant had limb hemangiomas, one elective abortion occurred, and two miscarriages were reported. Of the miscarriages, one had malpositioned, hypoplastic kidneys and the other had four toes on each foot, with bilateral webbing (Gililland and Weinstein, 1983), thus four of six first trimester-exposed pregnancies had birth defects.
Imaging of the Upper and Lower Urinary Tract: Radiology and Ultrasound
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
Andrea Tubaro, Kirsten Kluivers, Federica Puccini, Antonio Carbone
And ectopic And cAn sometimes be difficult to imAge unless delAyed films And tomogrAphy Are used (Figure 37.2) [35–37]. When the renAl moiety cAnnot be imAged on IVu And Ct, MrI or isotope scAnning is recommended [38–40]. IVu is still recommended in cAse of ureterovAginAl fistulA Although uro-Ct And uro-Mr cAn be Also used, And dilAtAtion of the uut is observed in 84%–92% of fistulA cAses [41,42]. CT And MRI both techniques hAve been recommended for the mAnAgement of pAtients with A suspected ectopic ureter becAuse of their Ability to imAge smAll, poorly functioning renAl moieties As well As the collecting system [43–46]. both Ct And MrI require normAl renAl function whenever contrAst medium is used, And Although Mr contrAst Agents were considered sAfe, they mAy cAuse Adverse effects [47–49]. Isotopes ScAnning Isotope scAnning is mAinly used to quAntify function of the individuAl renAl moieties And to locAte ectopic or poorly functioning kidneys. Whenever renAl function impAirment is suspected And sepArAte renAl function must be quAntified, isotope scAnning is the technique of choice. The interpretAtion of isotope scAnning is not AlwAys strAightforwArd As there Are vArious physiologicAl fActors And technicAl pitfAlls thAt cAn influence the results. These include the choice of rAdionucleotide, timing of diuretic injection, stAte of hydrAtion And diuresis, fullness or bAck pressure from the blAdder, vAriAble renAl function, And compliAnce of the collecting system [50,51]. When An ectopic ureter is suspected, renAl scintigrAphy mAy be successful in imAging hypoplAstic kidneys when other techniques hAve fAiled [52].
Mulibrey Nanism
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Mulibrey nanism is an congenital multi-organ disorder that typically manifests as prenatal onset growth failure (thin extremities 99% of cases, accentuated lumbar lordosis 96%, general gracility 95%, narrow shoulders 94%, small bell-shaped thoracic cage 94%, barrel-like trunk 92%, hypoplastic buttocks 52%), and abnormalities of the face (facial triangularity, high and broad forehead, low nasal bridge, telecanthus 90%, scaphocephaly 81%, hypoplastic tongue 80%, low-set located posteriorly rotated ears 54%, dental crowding 50%, high hairline 45%, wide fontanels and sutures in infancy 37%, abnormally wide metopic suture 31%, cleft palate 2%), eye (yellowish dots in the ocular fundi 79%), heart (cardiac anomaly 15%, cardiomegaly 14%, congenital heart failure 12%, dyspnea 12%, prominent veins on upper body 11%, pericardial constriction 6%, cyanosis on the lips and fingertips), muscle (muscular hypotonia 68%), liver (hepatomegaly 45%, hepatosplenomegaly 11%, ascites 11%), brain (J-shaped sella turcica—a depression in the sphenoid bone at the base of the skull 89%, large cerebral ventricles and basal cisternas 43%), urogenitals (renal anomaly 18%, hydronephrosis 6%, abnormally located kidney 5%, hypoplastic kidneys 5%, horseshoe kidney 2%, cryptorchidism 6%, prominent clitoris 2%, hyperplastic labiae 1%, spontaneous pubarche with menarche at median age 14.7 years), high-pitched voice (96%), skeletal asymmetry (15%), in addition to high risk for tumors (e.g., cutaneous nevi flammei 65%, Wilms tumor 6%, benign renal neoplasia 3%, hepatoblastoma 2%, fibrothecoma, ovarian mesenchymal tumor, ovarian adenofibroma, ovarian poorly differentiated adenocarcinoma, endometrial adenocarcinoma, gastrointestinal carcinoid tumor, neuropituitary Langerhans cell histiocytosis, acute lymphoblastic leukemia, thyroid tumor) (Figure 35.1) [21,22]. Other symptoms include feeding difficulties, respiratory tract infections, congestion in the lungs, buildup of fibrous tissue in the walls of the lungs (pulmonary fibrosis), swelling of the arms and/or legs (peripheral edema), unusually thin shinbone (fibrous tibia dysplasia), and early onset type 2 diabetes [23].
The comparison of the resistivity index values in the ultrasonographic evaluation of a unilateral atrophic/hypoplastic kidney
Published in Renal Failure, 2020
Tahir Dalkiran, Yasar Kandur, Besra Dagoglu, Hatice Saki, Sukru Gungor, Sevcan Ipek
We found lower RI values in atrophic kidneys than in hypoplastic kidneys. The S/D ratios were also lower in atrophic kidneys. In contrast, recent studies have shown that a high RI value (>0.70) is an independent risk factor for worsening the renal function in CKD, and that renal survival rate is significantly lower in the presence of a high RI value [13]. Many hormones, including renin-angiotensin, kallikrein-kinin, and prostaglandin-thromboxane, reduce vasodilatation and produce diffuse vasoconstriction [14]. We proposed that there was no sufficient prostaglandin and renin-angiotensin synthesis in atrophic kidneys, and thus vasoconstriction would not develop. However, in the case of hypoplastic kidneys, the presence of sufficient prostaglandin synthesis causes relative vasoconstriction. We supposed that the relative low RI values in atrophic kidneys are thought to be related to the low levels of these vasoconstrictors. However, prospective, well-designed diagnostic accuracy studies are needed to validate this hypothesis.