ABSTRACT
the aim of the study is to assess the effect of Inhaled steroids on bone density in male patients with bronchial asthma. this retrospective analysis included 102 male patients with bronchial asthma, mean age 51 years [range; 22-80]. All has been using inhaled beclomethasone dipropionate or budesonide with average dosage of 800 ug/day [600- 1200] at least for the last year. Patients then were subdivided into 3 groups according to duration of inhalational steroid use: group 1: < 5 years [n= 17], group 2: 5-10 years [n= 57] and group 3: >10years [n= 28]. Bone mineral density was measured from lumbar spine [LI-4] and non dominant proximal femur by dual energy X-Ray absorptiometry with a Hologic QDR-1000 densitometer [Holologic Inc., Waltham, Mass]. ANOVA test was used in statistical analysis and P<0.05 was considered significant. Over all frequency of osteoporosis and osteopenia within our study group were 48% and 43% respectively. In the left femur, those values were 58% and 8% respectively. Frequency of osteoporosis in lumbar vertebrae and left femur in the above 3 groups classified according to duration of inhalational steroid use were: group 1: 6% and 0%, Group 2: 42% and 9% and group 3: 71% and 5% respectively. BMDs, T-scores and Z- scores were lower in group 2 and 3 compared to group l [p<0.05]. our study shows high frequency of osteoporosis among men treated with inhalational steroids. Therefore, screening strategy is recommended within 5 years after initiation of treatment
ABSTRACT
To describe various types of congenital renal anomalies incidentally detected during routine DMSA scan in children with urinary tract infection, and to compare the incidence of scarring in patients with and without renal anomalies. This study included 400 subjects [138 boys and 262 girls], age range [one month to 15 years / Mean= 5.6 years]. In the period between May to December 2009, children were referred to Nuclear Medicine Center for Tc 99m DMSA scan to rule out renal scarring. Congenital anomalies appearance, scarring and function of kidneys were documented. Pearson correlation was used in statistical analysis and P<0.05 was considered significant. There were 55 cases of congenital kidney anomalies in our study [13.75%], within 29 boys and 26 girls. The most common congenital anomaly was single kidney seen in 17 cases [4.25%]. Renal scarring was detected in 31.25% of total cases [125 cases out of 400 cases], 30.9% of congenital anomalous kidneys [17 out of 55 cases], and in 31.3% of non-anomalous kidneys [108 out of 345 cases]. Congenital renal anomalies are not uncommon. Tc 99m DMSA scan is an adequate imaging modality to detect these anomalies and assess renal scarring. Patients with congenital anomalies did not show an increase in renal scarring compared to non-anomalous kidneys
ABSTRACT
Obstructive pattern within hydronephrotic non-obstructed kidney is frequently encountered during [99m] TCMAG3 diuretic renography. The aim of this study was to assess the value of applying new protocol and criteria on dual-time imaging in ruling out obstruction. We included 53 children [56 kidneys] in this study [28 boys and 25 girls with age range three weeks to 12 years]. All had hydronephrosis, which was bilateral in three children. Eighteen children had pyeloplasty, while 35 children had no previous surgical interventions. All children were referred for assessment of renal outflow obstruction and kidney function. All children underwent routine diuretic [99m]Tc MAG3 renal renography. All had obstructive patterns during diuretic [99m] TcMAG3 renography and underwent a second dynamic study 30 minutes later for 10 minutes. Non obstructive criteria were set as down sloping second time renogram with drop of kidney counts by 50% of peaked activity in first time renogram. Obstructive criteria on dual-time imaging were set as progressive rising second time renogram or flat second time renogram with drop of kidney counts by less than 30% compared to first time study. Equivocal criteria were set as flat renograms with drop of kidney activity by 3 0-50% or down sloping renogram with drop of kidney counts by<30% over 10 minutes. Non obstructive patterns were noticed in 16 kidneys 15 [patients], with down sloping curves during second time renograms in seven kidneys and flat second time renogram with drop of activity by> 50% in 9 kidneys. Obstructive patterns on dual time point [99m] TcMAG3 renography were noticed in 31 kidneys [29 patients]. Eleven kidneys [six patients] were false positive, since three patients had neurogenic bladder with no obstruction, two patients had long standing severe hydronephrosis with no obstruction and one patient had glomerulonephritis. Equivocal patterns were noticed in nine patients, four of them were turned to have significant obstruction, while five had no obstruction. Dual-time [99m] Tc-MAG3 diuretic renography can increase the efficiency in differentiating between obstructed and non-obstructed hydronephrosis compared to routine single time study
Subject(s)
Humans , Male , Female , Diuretics , Radioisotope Renography/methods , Hydronephrosis/methods , ChildABSTRACT
The aim of this study was to assess the diagnostic potential of [18]F-FDG Positron Emission Tomography imaging in the evaluation of patients with solitary pulmonary nodules, by comparing the diagnostic criteria in single time point imaging method to two different diagnostic criteria in dual-time-point imaging. This retrospective study was conducted in the Hospital of the University of Pennsylvania, and data was collected and analyzed in the period from September 2005 to March 2006, from the pooled hospital studies for the last eight years. Two hundred sixty five patients were included [161 men, 104 women, age range: 41-92 years]. All had solitary pulmonary nodules on computed tomography, and the diagnosis was confirmed by biopsy or by follow up computed tomography. All 265 patients underwent whole body FDG PET scan, and 255 of them had PET scan two time points. The maximum standardized uptake values of nodules were calculated for both time points. On single time point imaging we set the maximum standardized uptake value of 2.5 as a cutoff criterion for malignancy. On dual time point imaging, first criterion of malignancy was set as any increase in the maximum SUV from the first to second time point. The second criterion was set as either no change or increase in the maximum standardized uptake value between the two time points. Sensitivity, specificity and accuracy were calculated for the three methods by using the biopsy results and clinical follow up as gold standard. Biopsy and follow-up revealed 72 patients with malignant lung nodules, whereas 193 patients had benign nodules. Single time point imaging with a threshold maximum standardized uptake value of 2.5 had a sensitivity, specificity and accuracy of 63%, 92% and 85% respectively. On dual-time-point imaging, for the initial criterion for malignancy, the sensitivity, specificity and accuracy were 81%, 95% and 91% respectively. On dual time point imaging, for the second criterion for malignancy, the sensitivity, specificity and accuracy were 92%, 93%, and 92% respectively. Dual-time-point FDG PET imaging using both criteria has higher sensitivity, specificity and accuracy compared to single time imaging. Dual-time-point FDG PET imaging should be included in the clinical workup of patients with pulmonary nodule