AIM： To report our experience with computed tomography colonography （CTC） systematically performed in subjects with positive faecal occult blood test （FOBT） and an incomplete colonoscopy in the setting of a popul...AIM： To report our experience with computed tomography colonography （CTC） systematically performed in subjects with positive faecal occult blood test （FOBT） and an incomplete colonoscopy in the setting of a population-based screening for colorectal cancer （CRC）. METHODS： From April 2006 to April 2007, 43 290 individuals （age range 50-70） who adhered to the regional screening program for the prevention of CRC underwent immunochemical FOBT. FOBT was positive in 1882 subjects （4.3%）. 1463 （77.7%） of these subjects underwent colonoscopy, 903 performed in a single center. Of 903 colonoscopies 65 （7.2%） were incomplete. Forty-two of these subjects underwent CTC. CTC was performed with a 16-MDCT scanner after standard bowel prep （polyethyleneglycole） in both supine and prone position. Subjects whose CTC showed polyps or masses were referred to the endoscopist for repeat colonoscopy under sedation or underwent surgery. Perlesion and per-segment positive predictive values （PPV） were calculated. RESULTS： Twenty-one （50%） of 42 CTCs showed polyps or masses. Fifty-five of these subjects underwent a repeat colonoscopy, whereas 2 subjects underwent surgery for colonic masses of indeterminate nature. Four subjects refused further examinations. CTC correctly identified 2 colonic masses and 20 polyps. PPV for masses or polyps greater than 9 mm was of 87.5%. Per-lesion and per-segment PPV were, respectively, 83.3% and 83.3% for polyps greater or equal to 10 mm, and 77.8% and 85.7% for polyps of 6-9 mm. CONCLUSION： In the context of a screening program for CRC based on FOBT, CTC shows high per-segment and per-lesion PPV for colonic masses and polyps greater than 9 mm. Therefore, CTC has the potential to become a useful technique for evaluation of the non visualized part of the colon after incomplete colonoscopy.展开更多
<strong>Context: </strong>Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). <strong>Objective:</strong> This study...<strong>Context: </strong>Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). <strong>Objective:</strong> This study aims to demonstrate the effects of the most reliable non-invasive technique on thyroid nodules. <strong>Methods:</strong> Between 2016 and 2020, 190 patients with 214 nodules visiting King Khalid University Hospital were randomly selected and retrospectively reviewed. Following the ACR TI-RADS recommendations for FNA and correlating cytology reports. Two expert radiologists with ultrasonographic imaging experience re-evaluated and reviewed the images. 88 nodules (41%) in 79 patients were excluded because the nodule size was smaller than the FNA recommended size. <strong>Results:</strong> Following the ACR TI-RADS for FNA recommended selection, 27 nodules (21.4%) out of the recommended 126 nodules were consistent with malignancy in cytology, with overall mean sensitivities, specificities, accuracies, precisions, and negative predictive values (NPV) of 96.4%, 40.7%, 48.7%, 28.4%, and 98.6% respectively. The nodules were subdivided into the TI-RADS 3, 4, and 5.<strong> Conclusion:</strong> In conclusion, ACR TI-RADS is feasible, reliable, and well structured, easily applicable in thyroid nodules reporting. ACR TI-RADS can eliminate many unnecessary FNAs, providing a decline in costs and complications. We recommend the ACR TI-RADS in our radiology department to eliminate reporting discrepancies and cut costs, thereby standardizing the reports, improving intra-user agreements, and improving overall patients’ health care.展开更多
Dear Editor,We are writing this letter to present a very rare case of idiopathic orbital lipogranuloma.Lipogranuloma is a granulomatous inflammatory soft tissue reaction,consisting of lipid deposition and/or an oil-li...Dear Editor,We are writing this letter to present a very rare case of idiopathic orbital lipogranuloma.Lipogranuloma is a granulomatous inflammatory soft tissue reaction,consisting of lipid deposition and/or an oil-like substance commonly展开更多
BACKGROUND Individuals’interest in sports activities has been increasing,contributing to more stress fracture occurrences in uncommon locations on the skeleton.In this study,several cases of stress fractures in atypi...BACKGROUND Individuals’interest in sports activities has been increasing,contributing to more stress fracture occurrences in uncommon locations on the skeleton.In this study,several cases of stress fractures in atypical locations are presented,and the possibility of combining diagnostic methods to make accurate and quick diagnoses is explored.Additionally,different causes of stress fractures,as well as various modalities of treatment,are highlighted.Other potential factors of stress fractures were identified by a literature review.CASE SUMMARY Six cases of stress fractures in the calcaneus,intermediate cuneiform bone,sacrum,tibia(bilateral),navicular bone and femoral neck are presented,with different types of diagnostic imaging and treatments.All of the cases were associated with an aspect of mobility because all of the patients were physically active in various sport disciplines.CONCLUSION The type of therapeutic procedure selected should depend on the specific clinical case,i.e.,the patient’s condition and level of physical activity.展开更多
We report an unexpected massive left pneumothorax at the end of a digestive upper endoscopy without evidences of perforation or airway over-pressure. The possible air passage through a diaphragmatic failing is discussed.
Transplant recipients usually have increased chances of graft rejection and graft vs host disease,requiring chronic immunosuppressive therapy.Nonetheless,longterm immunosuppression risks malignancies such as skin canc...Transplant recipients usually have increased chances of graft rejection and graft vs host disease,requiring chronic immunosuppressive therapy.Nonetheless,longterm immunosuppression risks malignancies such as skin cancer,lymphoma,and Kaposi sarcoma.However,there are very few studies that included solid organ transplant recipients while studying the efficacy of immunotherapy.“Immunotherapy after liver transplantation:Where are we now?”is a study,where the authors described the mechanism of action and outcomes of immune checkpoint inhibitors specific to liver transplant recipients.The authors reported the graft rejection rates and the factors contributing to the rejection in the liver transplant recipients.展开更多
Objective: To determine the risk factors, clinical features,and outcome of infants diagnosed with portal vein thrombosis(PVT). Study design: A retrospective chart review was conducted of all consecutive infants admitt...Objective: To determine the risk factors, clinical features,and outcome of infants diagnosed with portal vein thrombosis(PVT). Study design: A retrospective chart review was conducted of all consecutive infants admitted to the Hospital for Sick Children, Toronto, between January 1999 and December 2003 diagnosed with PVT. Results: PVT was diagnosed in 133 infants, all but 5 of whom were neonates, with a median age at time of diagnosis of 7 days. An umbilical venous catheter(UVC) was inserted in 73%of the infants and was in an appropriate position in 46%of them. Poor outcome, defined as portal hypertension or lobar atrophy, was diagnosed in 27%of the infants and was significantly more common in those with an initial diagnosis of grade 3 PVT and in those with a low or intrahepatically placed UVC. Anticoagulation treatment did not appear to have a significant effect on outcome. Conclusions:PVT occurs early in life; major risk factors in addition to the neonatal period are placement of UVC and severe neonatal sickness. Poor outcome is associated with an improper lyplaced UVC and with grade 3 thrombus.展开更多
A 52-year-old woman,previously healthy was admitted to another hospital due to right upper quadrant abdominal pain,fever and leukocytosis.An ultrasound demonstrated acute cholecystitis and lesion 8 cm.in diameter near...A 52-year-old woman,previously healthy was admitted to another hospital due to right upper quadrant abdominal pain,fever and leukocytosis.An ultrasound demonstrated acute cholecystitis and lesion 8 cm.in diameter near the gallbladder.An abdominal CT scan showed the lesion in close proximity to the gallbladder,with fat infiltration.A percutaneous drainage of the lesion under CT guidance yielded a substance which was bloody and purulent in content.The patient improved clinically under antibiotics and was discharged from hospital with a recommendation for elective exploratory laparoscopy.展开更多
文摘AIM： To report our experience with computed tomography colonography （CTC） systematically performed in subjects with positive faecal occult blood test （FOBT） and an incomplete colonoscopy in the setting of a population-based screening for colorectal cancer （CRC）. METHODS： From April 2006 to April 2007, 43 290 individuals （age range 50-70） who adhered to the regional screening program for the prevention of CRC underwent immunochemical FOBT. FOBT was positive in 1882 subjects （4.3%）. 1463 （77.7%） of these subjects underwent colonoscopy, 903 performed in a single center. Of 903 colonoscopies 65 （7.2%） were incomplete. Forty-two of these subjects underwent CTC. CTC was performed with a 16-MDCT scanner after standard bowel prep （polyethyleneglycole） in both supine and prone position. Subjects whose CTC showed polyps or masses were referred to the endoscopist for repeat colonoscopy under sedation or underwent surgery. Perlesion and per-segment positive predictive values （PPV） were calculated. RESULTS： Twenty-one （50%） of 42 CTCs showed polyps or masses. Fifty-five of these subjects underwent a repeat colonoscopy, whereas 2 subjects underwent surgery for colonic masses of indeterminate nature. Four subjects refused further examinations. CTC correctly identified 2 colonic masses and 20 polyps. PPV for masses or polyps greater than 9 mm was of 87.5%. Per-lesion and per-segment PPV were, respectively, 83.3% and 83.3% for polyps greater or equal to 10 mm, and 77.8% and 85.7% for polyps of 6-9 mm. CONCLUSION： In the context of a screening program for CRC based on FOBT, CTC shows high per-segment and per-lesion PPV for colonic masses and polyps greater than 9 mm. Therefore, CTC has the potential to become a useful technique for evaluation of the non visualized part of the colon after incomplete colonoscopy.
文摘<strong>Context: </strong>Diagnostic imaging has increased the rate of thyroid nodules detection and improved utilization of fine-needle aspiration (FNA). <strong>Objective:</strong> This study aims to demonstrate the effects of the most reliable non-invasive technique on thyroid nodules. <strong>Methods:</strong> Between 2016 and 2020, 190 patients with 214 nodules visiting King Khalid University Hospital were randomly selected and retrospectively reviewed. Following the ACR TI-RADS recommendations for FNA and correlating cytology reports. Two expert radiologists with ultrasonographic imaging experience re-evaluated and reviewed the images. 88 nodules (41%) in 79 patients were excluded because the nodule size was smaller than the FNA recommended size. <strong>Results:</strong> Following the ACR TI-RADS for FNA recommended selection, 27 nodules (21.4%) out of the recommended 126 nodules were consistent with malignancy in cytology, with overall mean sensitivities, specificities, accuracies, precisions, and negative predictive values (NPV) of 96.4%, 40.7%, 48.7%, 28.4%, and 98.6% respectively. The nodules were subdivided into the TI-RADS 3, 4, and 5.<strong> Conclusion:</strong> In conclusion, ACR TI-RADS is feasible, reliable, and well structured, easily applicable in thyroid nodules reporting. ACR TI-RADS can eliminate many unnecessary FNAs, providing a decline in costs and complications. We recommend the ACR TI-RADS in our radiology department to eliminate reporting discrepancies and cut costs, thereby standardizing the reports, improving intra-user agreements, and improving overall patients’ health care.
文摘Dear Editor,We are writing this letter to present a very rare case of idiopathic orbital lipogranuloma.Lipogranuloma is a granulomatous inflammatory soft tissue reaction,consisting of lipid deposition and/or an oil-like substance commonly
文摘BACKGROUND Individuals’interest in sports activities has been increasing,contributing to more stress fracture occurrences in uncommon locations on the skeleton.In this study,several cases of stress fractures in atypical locations are presented,and the possibility of combining diagnostic methods to make accurate and quick diagnoses is explored.Additionally,different causes of stress fractures,as well as various modalities of treatment,are highlighted.Other potential factors of stress fractures were identified by a literature review.CASE SUMMARY Six cases of stress fractures in the calcaneus,intermediate cuneiform bone,sacrum,tibia(bilateral),navicular bone and femoral neck are presented,with different types of diagnostic imaging and treatments.All of the cases were associated with an aspect of mobility because all of the patients were physically active in various sport disciplines.CONCLUSION The type of therapeutic procedure selected should depend on the specific clinical case,i.e.,the patient’s condition and level of physical activity.
文摘We report an unexpected massive left pneumothorax at the end of a digestive upper endoscopy without evidences of perforation or airway over-pressure. The possible air passage through a diaphragmatic failing is discussed.
文摘Transplant recipients usually have increased chances of graft rejection and graft vs host disease,requiring chronic immunosuppressive therapy.Nonetheless,longterm immunosuppression risks malignancies such as skin cancer,lymphoma,and Kaposi sarcoma.However,there are very few studies that included solid organ transplant recipients while studying the efficacy of immunotherapy.“Immunotherapy after liver transplantation:Where are we now?”is a study,where the authors described the mechanism of action and outcomes of immune checkpoint inhibitors specific to liver transplant recipients.The authors reported the graft rejection rates and the factors contributing to the rejection in the liver transplant recipients.
文摘Objective: To determine the risk factors, clinical features,and outcome of infants diagnosed with portal vein thrombosis(PVT). Study design: A retrospective chart review was conducted of all consecutive infants admitted to the Hospital for Sick Children, Toronto, between January 1999 and December 2003 diagnosed with PVT. Results: PVT was diagnosed in 133 infants, all but 5 of whom were neonates, with a median age at time of diagnosis of 7 days. An umbilical venous catheter(UVC) was inserted in 73%of the infants and was in an appropriate position in 46%of them. Poor outcome, defined as portal hypertension or lobar atrophy, was diagnosed in 27%of the infants and was significantly more common in those with an initial diagnosis of grade 3 PVT and in those with a low or intrahepatically placed UVC. Anticoagulation treatment did not appear to have a significant effect on outcome. Conclusions:PVT occurs early in life; major risk factors in addition to the neonatal period are placement of UVC and severe neonatal sickness. Poor outcome is associated with an improper lyplaced UVC and with grade 3 thrombus.
文摘A 52-year-old woman,previously healthy was admitted to another hospital due to right upper quadrant abdominal pain,fever and leukocytosis.An ultrasound demonstrated acute cholecystitis and lesion 8 cm.in diameter near the gallbladder.An abdominal CT scan showed the lesion in close proximity to the gallbladder,with fat infiltration.A percutaneous drainage of the lesion under CT guidance yielded a substance which was bloody and purulent in content.The patient improved clinically under antibiotics and was discharged from hospital with a recommendation for elective exploratory laparoscopy.
