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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Gastroparesis is diagnosed after other causes are excluded, with postprandial gastric stasis confirmed by gastric emptying scintigraphy. This involves ingesting a technetium-labeled egg meal. Gastric emptying is measured by scintiscanning at 15-minute intervals over 4 hours. Retention of 10% or more of the meal at the end of 4 hours confirms gastroparesis. Other tests include antroduodenal manometry, a breath test using a nonradioactive isotope carbon-13 bound to a digestible substance, electrogastrography, MRI, and ultrasonography. Upper endoscopy or an upper GI series with small bowel assessment can rule out mechanical obstruction or other GI conditions. Ultrasonography is done if there are biliary tract symptoms or extreme abdominal pain.
Fetal surgery
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Emily A. Partridge, Alan W. Flake
Patients suspected of carrying a fetus with a major anomaly should be referred to a fetal treatment center for comprehensive multidisciplinary evaluation. Evaluation should include detailed ultrasonographic characterization, fetal echocardiography, and often ultrafast magnetic resonance imaging (MRI). Fetal US was first described in the late 1960s, and remains the primary imaging modality for prenatal screening and diagnosis with its proven utility, relatively low cost, and widespread availability. Further, ultrasonography is advantageous due to its multiplanar capability, Doppler flow depictions, high spatial resolution, and real-time assessment. Limitations of ultrasonography include a relatively small field of view, beam attenuation by maternal adipose tissue, poor image quality in oligohydramnios, poor acoustic access to the fetal head when it lies deeper in the pelvis, and limited visualization of the posterior fossa due to calvarial calcification later in gestation.
Prediction of pre-eclampsia
Published in Pankaj Desai, Pre-eclampsia, 2020
Ultrasonography is one development in science that changed the face of how obstetrics is practiced. Gone are the days when so much was left to the imagination. X-rays were the only principle imaging modality for medical science until as late as the early 1980s. Students of the subject who have been a witness to the introduction of ultrasonography for widespread use in clinical practice have experienced the joy and ease of diagnosing and managing obstetric situations hitherto left to clinical evaluation and imagination. What began as a non-invasive imaging technique to study the blood supply and its complexities has become a potent weapon for effective prediction, prognostication and decision making in different stages of different obstetric vasculopathies, including pre-eclampsia.
Application of dual-energy CT angiography in diagnosis of arterial erectile dysfunction: new scanning technology, new scanning area
Published in The Aging Male, 2022
Ming Wang, Yutian Dai, Hui Jiang, Andrea Sansone, Emmanuele A. Jannini, Xiansheng Zhang
Penile erection depends on synergistic mechanisms between psychologic, neural, endocrine and vascular systems, and therefore ED can be caused by any defect in these systems [39]. Decreased perfusion of penile arteries caused by arterial lesions is an important cause of vasculogenic ED. Currently, penile duplex Doppler ultrasound (PDDU) is treated as the gold standard for diagnosis of vascular ED because of the high sensitivity in the assessment of penial hemodynamics and significant correlation with arteriography [16,17]. However, there are some obvious limitations to ultrasonography. First, the diagnosis is highly susceptible to the skill and experience of operator, and the value relies on Doppler cursor angle and anatomic location [40]. Second, the result is considered to be affected by psychological disturbance such as anxiety and nervousness, especially in young patients [41]. Finally, it is unable to fully evaluate penile arteries, focusing only on selected vessels [36]. Additional diagnostic tests, such as cavernosometry and cavernosography, have also been used in the investigation of ED, but are considered “third line” options in the clinical setting, being invasive and complicated procedures [42].
Is there a role for growth status in distinguishing gallbladder adenomas from cholesterol polyps? – A retrospective study based on 520 cholecystectomy patients
Published in Scandinavian Journal of Gastroenterology, 2021
Wenqing Bao, Anan Xu, Shubin Ni, Bo Wang, Humaira Urmi, Bin Zhao, Yongmei You, Hai Hu
We retrospectively analyzed the data of patients pathologically proven GPs from December 2018 to January 2021 in two hospitals (Gallbladder Diseases Center, Shanghai East Hospital, Tongji University; Department of General Surgery, Shanghai Seventh People’s Hospital, Shanghai University of Traditional Chinese Medicine). The inclusion criteria for GPs patients were as follows: (i) patients underwent cholecystectomy and had a definite pathological diagnosis, (ii) underwent more than twice preoperative ultrasonography examination at a time interval of more than 6 months, and (iii) ultrasonography examination was performed within 1 month before surgery. The exclusion criteria were: (i) patients younger than 18 years, (ii) comorbid with other abdominal cancers, (iii) patients lacking the necessary clinical file, and (iv) patients with known gallbladder gallstones on ultrasonography preoperatively.
Ultrasonographic findings of shoulders in individuals with spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2021
Patpiya Sirasaporn, Jittima Saengsuwan, Rattana Vichiansiri
A variety of shoulder pathologies in SCI patient have been diagnosed by ultrasonography such as bicipital tendinopathy, acromioclavicular joint abnormalities, rotator cuff disease, subacromial-subdeltoid bursitis, subacromial spurs, and effusion in the glenohumeral joint space.6,11,13,14 Ninomyia et al. observed that shoulder ultrasound diagnosed abnormalities in at least one structure in 87.5% of SCI patients.14 Plain radiographic methods are useful to evaluate bony structures in shoulder pain but are limited in accessing soft tissue lesions.15 Ultrasonography is a noninvasive, radiation-free, extremely accessible, and inexpensive imaging technique that can be used for soft tissue assessment. It combines direct static and dynamic investigation of movement, thereby providing both anatomic and functional elements to the assessment.16 The European Society of Musculoskeletal Radiology, highly recommends shoulder ultrasonography for clinical indications such as subacromial-subdeltoid bursitis, rotator cuff tears, calcific tendonitis, long head of biceps disease, and septic arthritis.17,18