ABSTRACT
Purpose: To compare the detection of urinary stones using standard gray scale ultrasound for diagnostic accuracy using the color Doppler "twinkling sign". Material and Methods: Our study population consisted of forty-one patients who demonstrated at least one urinary stone on unenhanced CT evaluation of the kidneys or ureters. Each patient was evaluated using gray scale ultrasound and color Doppler imaging by an observer who was blinded to the CT results. Results: Seventy-seven stones were present in 41 patients, including 47 intrarenal stones, 5 stones in the renal pelvis, 8 stones at the ureteropelvic junction, 5 ureteral stones and 12 stones at the ureterovesical junction. Based upon gray scale sonography the diagnosis of stone was made with confidence in 66 percent (51/77) of locations. Based upon Doppler sonography using the twinkling sign, the diagnosis of stone was made with confidence in 97 percent (75/77) of locations. Clustered ROC analysis demonstrated that the Doppler twinkling sign (Az = 0.99) was significantly better than conventional gray scale criteria (Az = 0.95) for the diagnosis of urinary stones (p = 0.005, two-sided test). Conclusions: The color Doppler twinkling sign improves the detection, confidence and overall accuracy of diagnosis for renal and ureteral stones with minimal loss of specificity.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Kidney Calculi , Ultrasonography, Doppler, Color , Ureteral Calculi , Contrast Media , Kidney Calculi , Reproducibility of Results , ROC Curve , Sensitivity and Specificity , Tomography, X-Ray Computed , Ureteral Calculi , Young AdultABSTRACT
La tianeptina como medicamento no nicotínico para reducir el daño producido por el hábito tabáquico. La tianeptina, medicamento comunmente usado en la práctica diaria actúa como antidepresivo estimulando la recaptación de serotonina. Asimismo esta droga posee propiedades ansiolíticas. Se trata de un medicamento bien tolerado y sus efectos anticolinérgicos son escasos. Asimismo este medicamento ha sido utilizado exitosamente en el tratamiento de la depresión consecutivo a la abstinencia alcohólica. La tíaneptina a la dosis de 24 mg por día en dos tomas resulta en una potente arma farmacológica para enfrentar las virtudes psicológicas de la abstinencia tabáquica. El objetivo del presente trabajo es estudiar la efectividad de la tianeptina en un grupo de pacientes con dependencia tabáquica.