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1.
Surg Radiol Anat ; 42(4): 397-400, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31897656

ABSTRACT

The aberrant left pulmonary artery and the aberrant right subclavian artery are rare congenital vascular anomalies, and the tracheal bronchus is a rare congenital respiratory anomaly. A 33-year-old female patient, with a history of desmoplastic medulloblastoma, was surgically treated at our hospital for a meningioma. On the second postoperative day, the patient complained of shortness of breath and chest pain. Contrast-enhanced multislice computed tomography was negative for pulmonary embolism, but incidentally revealed all three congenital anomalies. In our report, we detail this exceedingly rare case.


Subject(s)
Bronchi/abnormalities , Pulmonary Artery/abnormalities , Subclavian Artery/abnormalities , Adult , Bronchi/diagnostic imaging , Female , Humans , Incidental Findings , Medulloblastoma/surgery , Meningioma/surgery , Multidetector Computed Tomography , Postoperative Complications/diagnostic imaging , Pulmonary Artery/diagnostic imaging , Subclavian Artery/diagnostic imaging
2.
J Appl Microbiol ; 125(1): 84-95, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29517825

ABSTRACT

AIM: This study aimed to test biofilm inhibition activities of each of essential oils (EOs), main compounds of EOs and enzymes against pathogenic Klebsiella pneumoniae. METHODS AND RESULTS: The effect of seven EOs and three enzymes was tested on formation and eradication of K. pneumoniae biofilm. Peppermint oil showed a robust biofilm inhibitory effect, causing inhibition that ranged from 69·2 to 98·2% at 5 µl ml-1 . Thyme oil was found to have the best biofilm eradication ability, causing eradication that ranged from 80·1 to 98·0% at 10 µl ml-1 . The most effective EOs were analysed by GC/MS, to determine the major chemical constitutes of each oil. Pure menthol was found to cause 75·3-97·5% biofilm inhibition at 2·5 µg ml-1 , whereas thymol caused 85·1-97·8% biofilm eradication at 5 µg ml-1 . However, moderate inhibition activity was detected for α-amylase and bromelain, while poor activity was detected for ß-amylase. Ciprofloxacin combination with thyme oil and thymol was found to enhance antibiotic activity, and affect biofilm cell viability. The observed inhibitory/eradication activity on K. pneumoniae biofilms was confirmed by scanning electron microscopy. CONCLUSIONS: Thyme and peppermint EOs, and their active components are promising antibiofilm agents alone and/or in combination with ciprofloxacin to inhibit/eradicate biofilms of K. pneumoniae. SIGNIFICANCE AND IMPACT OF THE STUDY: The presented results suggest the potential application of EOs against infections, caused by biofilm-producing K. pneumoniae, to prevent biofilm formation or decrease their resistance threshold. Moreover, the combination of EOs with ciprofloxacin minimizes the antibiotic concentration used and accordingly the potential accompanying toxic side effects.


Subject(s)
Biofilms/drug effects , Ciprofloxacin/pharmacology , Drug Resistance, Multiple, Bacterial/drug effects , Klebsiella pneumoniae/drug effects , Oils, Volatile/pharmacology , Anti-Bacterial Agents/pharmacology , Drug Synergism , Klebsiella pneumoniae/growth & development , Klebsiella pneumoniae/physiology , Microbial Sensitivity Tests
3.
Surg Radiol Anat ; 39(10): 1169-1173, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28396980

ABSTRACT

A 76-year-old male patient underwent magnetic resonance angiography of the head and neck vessels due to a recent incident of transitory ischemic attack. Cerebral angiogram uncovered the double proximal origin of the median unpaired pericallosal artery from the duplicated anterior communicating complex. The vessel curved around the corpus callosum and irrigated the paracentral lobule and the medial parietal cortical areas. The main trunks of the anterior cerebral arteries showed a branching pattern of the marginal callosal arteries, supplying orbital and frontal territories. The pre-communicating segment of the left anterior cerebral artery was identified as hypoplastic. The co-existence of the duplicated anterior communicating artery, with the medial pericallosal artery ascending from it, represents a potential danger for both open and endovascular surgery on the anterior circle of Willis as the deep half of this complex is obscured from the surgeon's eyes. Thorough interpretation of preoperative radiographic images and understanding of the developmental mechanisms of such variability are vital. The described branching arrangement of the anterior communicative region and possible mechanisms of migration with following fusion of the pericallosal arteries are discussed in this paper.


Subject(s)
Anterior Cerebral Artery/abnormalities , Anterior Cerebral Artery/diagnostic imaging , Cerebral Angiography , Magnetic Resonance Angiography , Aged , Corpus Callosum/blood supply , Humans , Male
4.
Int. j. morphol ; 34(3): 1087-1091, Sept. 2016. ilus
Article in English | LILACS | ID: biblio-828990

ABSTRACT

A hospital based prospective study was conducted from July 2001 to July 2015 at the Department of Radiology, Jordan University Hospital, Amman, Jordan. During that period, five cases of double inferior vena cava (DIVC) were discovered among a cohort of 7722 patients (3861 men and 3861 women, 49.5±16.9 years, range 16­78 years). Cases were diagnosed by contrast-enhanced Spiral CT venography (CTV) and confirmed by turbo three-dimensional (3D) time-of-flight contrast-enhanced MR venography. The majority of patients 3166 (41 %) were referred for staging and follow-up of malignancy, postoperative complications 1777 (23 %), non-specific abdominal pain 1467 (19 %), preoperative assessment 849 (11 %) and trauma 463 (6 %). Magnetic resonance venography showed higher sensitivity, diagnostic accuracy and noninvasive modality for assessment of IVC map. MRV is a more useful, noninvasive modality for assessment of IVC map. DIVC is a common anomaly, its incidence in our study found to be 0.064 %. The incidence, literature review, embryogenesis, and importance of this anomaly are discussed. In addition, sample figures of relevant cases are provided.


En el Departamento de Radiología del Hospital de la Universidad de Jordania, Amman, Jordania, se llevó a cabo un estudio prospectivo entre el mes de julio de 2001 al mes de julio del 2015. Durante ese período se descubrieron cinco casos de vena cava inferior doble (VCID) en una cohorte de 7722 pacientes (3861 hombres y mujeres 3861, de 49,5 ± 16,9 años, con un rango de edad de 16-78 años). Los casos fueron diagnosticados por medio de venografía por tomografía computada espiral con contraste (TCV) y confirmados por medio de venografía por estudio tridimensional turbo. La mayoría de los pacientes (3166, 41 %) fueron remitidos para estadificación y seguimiento de tumores malignos. Se presentaron complicaciones postoperatorias en 1777 pacientes (23 %), dolor abdominal no especificado en 1467 (19 %), evaluación preoperatoria en 849 (11 %) y traumatismo en 463 pacientes (6 %). La venografía por resonancia magnética (RMV) mostró una mayor sensibilidad, precisión diagnóstica, y resultando no invasiva para la evaluación de la vena cava inferior (VCI). RMV es una modalidad más útil, no invasiva para la evaluación de la VCI. VCID es una anomalía frecuente, encontrándose en nuestro estudio una incidencia de 0,064 %. Además se realizó una revisión de la literatura, la embriogénesis, y la importancia de esta anomalía. También, se proporcionaron cifras de muestras de los casos relevantes.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Phlebography/methods , Vena Cava, Inferior , Vena Cava, Inferior/abnormalities , Jordan , Magnetic Resonance Imaging , Prospective Studies , Tomography, X-Ray Computed , Vena Cava, Inferior/embryology
5.
J Stroke Cerebrovasc Dis ; 25(10): 2559-65, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27492944

ABSTRACT

BACKGROUND AND PURPOSE: Noncontrasted computed tomography (NCCT) is used as the initial neuroimaging test of choice for patients who present with new-onset neurological symptoms. An apparently hyperattenuated venous sinus may lead to the suspicion of cerebral venous sinus thrombosis (CVST). Improved understanding of all factors that can affect attenuation of dural sinuses can guide triage of patients to or from further investigations of suspected CVST. The purpose of this retrospective study was to assess the effect of different factors including hematocrit (HCT), hemoglobin (Hb), age, BUN/Cr ratio (blood urea nitrogen-to-creatinine ratio), and gender on the attenuation of dural sinuses on brain NCCT. METHODS: A total of 1293 patients with neurological symptoms who presented to the emergency department were included in this study. For each patient, clinical assessment, laboratory investigations, and brain NCCT were reviewed. For each brain NCCT, the average attenuation of superior sagittal sinus and both right and left sigmoid sinuses was measured. RESULTS: Positive significant correlations were found between average attenuation of dural sinuses on one hand and each of age, Hb, and HCT on the other hand. No significant correlation was found between average attenuation and BUN/Cr ratio. Gender discrepancy was also significant as higher attenuation was found in men. CONCLUSION: Age, gender, and Hb levels are the main factors that should be taken into account upon the assessment of dural sinuses on brain NCCT. The highest normal attenuation is predicted in an elderly polycythemic man and the lowest is predicted in a young anemic woman.


Subject(s)
Cranial Sinuses/diagnostic imaging , Multidetector Computed Tomography , Sinus Thrombosis, Intracranial/diagnostic imaging , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Biomarkers/blood , Child , Child, Preschool , Female , Hemoglobins/analysis , Humans , Infant , Male , Middle Aged , Predictive Value of Tests , Retrospective Studies , Sex Factors , Sinus Thrombosis, Intracranial/blood , Young Adult
6.
J Pediatr Ophthalmol Strabismus ; 53: e35-8, 2016 Jul 30.
Article in English | MEDLINE | ID: mdl-27486892

ABSTRACT

A 5-year-old boy presented to the ophthalmology department complaining of absent tearing while crying. Slit-lamp examination showed decreased tear margin film with normal punctae. Orbit magnetic resonance imaging was done and showed bilateral absent lacrimal glands. This is the third case of isolated bilateral lacrimal gland agenesis in the literature. [J Pediatr Ophthalmol Strabismus. 2016;53:e35-e38.].


Subject(s)
Eye Abnormalities/diagnostic imaging , Lacrimal Apparatus/abnormalities , Child, Preschool , Eye Abnormalities/metabolism , Humans , Lacrimal Apparatus/diagnostic imaging , Lacrimal Apparatus Diseases/diagnostic imaging , Lacrimal Apparatus Diseases/metabolism , Magnetic Resonance Imaging , Male , Pedigree , Tears/metabolism , Tomography, X-Ray Computed
7.
J Med Case Rep ; 10: 12, 2016 Jan 19.
Article in English | MEDLINE | ID: mdl-26786137

ABSTRACT

BACKGROUND: Pyogenic abscess of psoas muscles is a rare condition. Psoas abscess due to methicillin-resistant Staphylococcus aureus is an emerging and rare infection and so far the related data are scarce. CASE PRESENTATION: We report the rare case of primary and bilateral large psoas abscesses due to methicillin-resistant Staphylococcus aureus in a 54-year-old Arab Jordanian woman with breast cancer who had neutropenia after starting chemotherapy. She was diagnosed 50 days after onset of symptoms. However, despite this delay in diagnosis and the large size of the abscesses, she had a full recovery. She was treated with antibiotics and percutaneous drainage and was doing very well at a follow up of 18 months. CONCLUSIONS: Psoas abscess due to methicillin-resistant Staphylococcus aureus might have insidious presentation with extensive disease especially in immunocompromised patients. However, it can be managed effectively with percutaneous catheter drainage and appropriate antibiotic therapy.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Antineoplastic Agents/adverse effects , Breast Neoplasms/drug therapy , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Neutropenia/chemically induced , Psoas Abscess/microbiology , Staphylococcal Infections/complications , Breast Neoplasms/complications , Breast Neoplasms/immunology , Drainage/methods , Female , Humans , Middle Aged , Neutropenia/immunology , Psoas Abscess/drug therapy , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , Treatment Outcome
9.
Int. j. morphol ; 33(4): 1411-1418, Dec. 2015. ilus
Article in English | LILACS | ID: lil-772331

ABSTRACT

This study aims at establishing whether transverse diameter (TD) and cross sectional-area (CSA) of the ascending aorta (AA), descending aorta (DA) and pulmonary trunk (PT) measured by computerized tomographic angiography (CTA) altered by sex, age, hypertension, smoking and diabetes. CTA examinations of the TD and CSA of the AA, DA and PT of 100 patients aged 49.5±16.9 years (range 16­78 years) selected between January 2009 to May 2011 from those referred to Radiology Department, Jordan University Hospital, Faculty of Medicine, University of Jordan, Amman, Jordan for advanced evaluation. Measurements were made in the axial plane at the upper border of the six thoracic vertebrae. Patients were divided into three age groups. Significance of differences in parameters between age groups was calculated. Assessment ratios were considered. It was found that parameters of the three arteries were significantly larger in men than in women (P= < 0.05) and increased with age. Hypertension increased diameters of AA and DA in both genders (P= 0.001) and of PT in men (P= 0.01). Smoking significantly decreased parameters of PT in men (P= 0.01). Diabetes increased parameters of the three arteries in both genders, significantly increased parameters of PT in men (P= <0.05) and parameters of DA in women (P= <0.05). It is concluded that studied parameters were larger in men and increased with age of our patients. Distinctive differences in measurements appeared in hypertensive, smokers, and diabetic patients.


El objetivo fue determinar si el sexo, edad, hipertensión, tabaquismo y la diabetes alteran el diámetro transversal (DT) y área transversal (AT) de la parte ascendente de la aorta (AA), parte descendente de la aorta (AD) y tronco pulmonar (TP), medidos por angiografía por tomografía computadorizada (ATC). Exámenes de ATC de 100 pacientes de 49,5±16,9 años (rango 16­78 años) fueron seleccionados entre enero del año 2009 a mayo del año 2011 por el Departamento de Radiología, Hospital de la Universidad de Jordania, Facultad de Medicina de la Universidad de Jordania, Amman, Jordania para una evaluación avanzada del DT y AT de la AA, AD y TP. Las mediciones se realizaron en el plano axial en el margen superior de las seis vértebras torácicas. Los pacientes fueron divididos en tres grupos según edad. Se determinó la existencia de significancia estadística de los diferentes parámetros entre los grupos etarios. La evaluación de las razones también fueron consideradas. Se encontró que los parámetros de las tres arterias fueron significativamente mayores en los hombres que en las mujeres (p= <0,05) y que aumentaron con la edad. La hipertensión aumentó los diámetros de la AA y AD en ambos sexos (p= 0,001) y del TP en los hombres (p= 0,01). En fumadores disminuyeron significativamente los parámetros del TP en los hombres (p= 0,01). La diabetes aumentó los parámetros de las tres arterias en ambos sexos. Ademas, aumentaron significativamente los parámetros del TP en los hombres (p= <0,05) y los parámetros de la AD en las mujeres (p = <0,05). Se concluye que los parámetros estudiados eran mayores en los hombres y aumentaron con la edad de nuestros pacientes. Diferencias distintivas en las mediciones aparecieron en hipertensos, fumadores y pacientes diabéticos.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Aorta/diagnostic imaging , Aorta/pathology , Pulmonary Artery/pathology , Age Factors , Aorta, Thoracic/diagnostic imaging , Aorta, Thoracic/pathology , Computed Tomography Angiography , Diabetes Mellitus/pathology , Hypertension/pathology , Pulmonary Artery/diagnostic imaging , Sex Factors , Tobacco Use Disorder/pathology
10.
Saudi Med J ; 36(8): 967-72, 2015 Aug.
Article in English | MEDLINE | ID: mdl-26219448

ABSTRACT

OBJECTIVES: To estimate normal linear dimensions and volume of spleen in Jordanians using ultrasonography, and to correlate splenic volume with age and body parameters: height, weight, body surface area (BSA), and body mass index (BMI). METHODS: A prospective pilot study was conducted on 205 volunteers (115 males and 90 females) not known to have any conditions likely to be associated with splenomegaly. The study was performed at the Radiology Department, Jordanian University Hospital, Amman, Jordan, between December 2013 and August 2014. All linear dimensions of spleen were measured, and splenic volume (index) was calculated using the standard prolate ellipsoid formula (length × width × depth × 0.523). The splenic volume was then analyzed with age and body parameters using the Pearson's correlation coefficient. RESULTS: The mean (± SD) splenic dimensions were 10.72±1.37 cm in length, 7.40±1.52 cm in width, 4.40±1.47 cm in depth, and 184.15±79.56 cm3 in volume. Men had larger spleens than women (p less than 0.0001). Age had no significant effect on spleen volume (r=0.11, p=0.12). There was a significant moderate positive correlation (p less than 0.0001), using Pearson's correlation coefficient, between the spleen volume, and other parameters (height, weight, BSA, and BMI), with correlation coefficients exceeding 0.3. CONCLUSION: A local reference of spleen dimensions was established with a different range of values reported previously.


Subject(s)
Spleen/anatomy & histology , Spleen/diagnostic imaging , Anthropometry , Female , Humans , Jordan , Male , Organ Size , Pilot Projects , Prospective Studies , Reference Values , Sex Factors
11.
Int J Surg Case Rep ; 4(2): 229-31, 2013.
Article in English | MEDLINE | ID: mdl-23291329

ABSTRACT

INTRODUCTION: Oral ranula is a retention cyst that arises from the salivary gland with recurrence rate of up to 25% after complete excision of ranula and up to 2% in case of complete excision of ranula and sublingual gland. Major salivary gland aplasia is a rare finding that is usually associated with other developmental anomalies. PRESENTATION OF CASE: We report a 15-year-old female patient presented with recurrent intraoral cystic swelling that was documented to be sublingual ranula. CT scan revealed also the absence of right submandibular salivary gland with persistence of its Whartons duct. This combination has never been reported previously. DISCUSSION: The combination of recurrent sublingual ranula associated with aplasia of ipsilateral submandibular salivary gland and persistence of Whartons duct has never been reported before in the literature, a finding that may provide the base for future research. CONCLUSION: Further research may prove similar associations between oral ranula and salivary gland aplasia, which may have clinical implications on diagnostic and management plan decisions.

12.
Endocr Pathol ; 24(1): 36-9, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23307110

ABSTRACT

Solitary metastasis from prostate adenocarcinoma to thyroid gland is very rare and usually associated with other distal metastasis. This report describes for the first time isolated multiple bilateral thyroid metastasis from prostatic adenocarcinoma. A 67-year-old man who is known as a case of prostatic adenocarcinoma was admitted to a hospital as a case of a multinodular goiter on the basis of clinical and CT scan findings. Total thyroidectomy was performed and histopathology result showed adenomatous goiter containing bilateral metastatic prostatic adenocarcinoma. This is the first report of isolated multiple bilateral thyroid gland metastasis from prostatic adenocarcinoma without other distal metastasis. Such lesions are very rare and can be misdiagnosed, so high index of suspicion for thyroid metastasis should be always maintained in all oncology patients with isolated thyroid mass because early resection and thyroidectomy will change the prognosis for patient.


Subject(s)
Adenocarcinoma/pathology , Adenocarcinoma/secondary , Prostatic Neoplasms/pathology , Thyroid Neoplasms/secondary , Aged , Humans , Immunohistochemistry , Male , Prostate-Specific Antigen/analysis , Thyroidectomy , Tomography, X-Ray Computed , Treatment Outcome
14.
Eur. j. anat ; 16(2): 150-156, mayo 2012. ilus, tab
Article in English | IBECS | ID: ibc-108906

ABSTRACT

Variability of the third segment (V3) of vertebral artery (VA) in correlation with individual shape of skull was studied by analyses of 32 MRI and angiograms of 64 arteries. According to value of cranial index, the group under research was divided into three subgroups: dolichocephalic (15.6%), mesocephalic (43.8%), and brachycephalic (40.6%). The V3 was studied according to its conventional division into three sections: vertical (vV3), horizontal (hV3), and oblique (oV3), with proximal and distal loop formations along its length. The mean diameter and length of vV3 and hV3 had minimal value in the patients with brachycephalic shape of skull. The angle between bends of proximal loop of V3 progressively increased from 67.5 ± 0.75 degree in the dolichocephalic group to 77.1 ± 0.44 degree in the brachycephalic group, while the angle between bends of distal loop was decreasing from the dolichocephalic group (79.6 ± 4.7 degree) to the mesocephalic group (74.85 ± 2.4), reaching the minimal value in the brachycephalic group (79.6 ± 4.7 degree). In the dolichocephalic group downward deviation of hV3 was more in evidence than in all the rest groups, with inclination to minimal or zero-deviation in brachycephalic group. The results have showed that the anatomical variability of V3 significant correlates with the shape of skull. The findings open up possibilities for primary diagnosis and prognosis of acute and chronic disorders in posterior circulation enabling to choose the individual surgical approach to the craniocervical junction and base of skull (AU)


No disponible


Subject(s)
Humans , Vertebral Artery/anatomy & histology , Skull/anatomy & histology , Cephalometry/methods , Cervical Vertebrae/blood supply , Skull Base/blood supply , Magnetic Resonance Imaging
16.
Neurosciences (Riyadh) ; 15(4): 280-3, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20956929

ABSTRACT

Secondary aneurysmal bone cyst in fibrous dysplasia is exceedingly rare, especially in the skull and particularly in the frontal bone. We present a case of aneurysmal bone cyst concomitant with fibrous dysplasia in the frontal bone in a 15-year-old male patient presenting with headache and euphoria with an uncharacteristic imaging appearance and treated successfully by total resection.


Subject(s)
Bone Cysts, Aneurysmal/complications , Fibrous Dysplasia of Bone/complications , Fibrous Dysplasia of Bone/pathology , Frontal Bone/pathology , Adolescent , Bone Cysts, Aneurysmal/surgery , Fibrous Dysplasia of Bone/surgery , Frontal Bone/surgery , Humans , Magnetic Resonance Imaging/methods , Male
17.
Neurosciences (Riyadh) ; 15(1): 11-4, 2010 Jan.
Article in English | MEDLINE | ID: mdl-20677585

ABSTRACT

OBJECTIVES: To present our experience in operated meningioma cases regarding their prevalence, anatomical location, multiplicity, presenting signs and symptoms, and the possible correlation between MRI signal intensity and histological grades to set criteria for radio-pathological diagnosis. METHODS: In this retrospective study, operated meningioma cases in the Department of Neurosurgery, Jordan University Hospital (JUH), Amman, Jordan between January 1997 and January 2007 were reviewed. Our study included 90 cases, and their medical records, histopathological reports, and neuroimages were analyzed thoroughly. RESULTS: Meningioma was more common in females than males with a ratio of 2.2:1. Para-sagittal meningiomas were the most common (23.3%). Multiple intracranial meningiomas were found in 4.4% of the cases. Most cases were of benign histopathology and exhibited iso-intense signals on T1 and T2, and appeared with hyper-intense signals on FLAIR with vivid enhancement. CONCLUSION: The prevalence of meningioma among genders and its anatomical location at JUH corresponds to the published medical literature worldwide. There was no correlation between signal intensities (as seen on T1WI, T2WI, and FLAIR sequences), enhancement pattern on one side, and histological grades on the other side.


Subject(s)
Meningeal Neoplasms/epidemiology , Meningeal Neoplasms/pathology , Meningioma/epidemiology , Meningioma/pathology , Adult , Aged , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Retrospective Studies , Statistics as Topic , Young Adult
18.
Saudi J Kidney Dis Transpl ; 21(3): 488-93, 2010 May.
Article in English | MEDLINE | ID: mdl-20427874

ABSTRACT

This study was conducted to assess the diagnostic yield of B-Mode Ultrasonography compared to unenhanced helical CT scan in detecting urinary stones in patients with acute renal colic. This retrospective study comprised of 156 patients who underwent unenhanced urinary tract CT scan and ultrasonography for suspicion of urolithiasis. Both techniques were used to determine the presence or absence, site, size, and number of urinary stones, as well as presence of any other intra-abdominal pathology. For statistical analysis, the sensitivity, specificity, predictive values, and diagnostic accuracy of ultrasonography were measured considering unenhanced CT scan as a gold standard. Unpaired two-tailed student's t-test was used for comparison between mean size of true positive, false positive, and false negative stones. There were 68 patients having 115 urinary stones. Ultrasound identified 54 stones, missed 43, and falsely diagnosed 18 stones. The mean size of true positive, false positive, and false negative stones were 4.8 +/- 3.3 mm, 6 +/- 1.8 mm and 4.18 +/- 3 mm, respectively. There were 23 patients with other intra-abdominal pathologies, equally detected by both techniques. Ultrasound helped in identifying the cause of acute flank pain in 62% of cases. The overall sensitivity, specificity, positive and negative predictive values, and accuracy of ultrasonography in the diagnosis of renal stone disease were 58%, 91%, 79%, 78%, and 78%, respectively. Our study suggests that, despite its limited value in detecting urinary stones, ultrasonography should be performed as an initial assessment in patients with acute flank pain. Unenhanced helical CT should be reserved for patients in whom ultrasonography is inconclusive.


Subject(s)
Renal Colic/diagnostic imaging , Urolithiasis/diagnostic imaging , Adult , Aged , False Negative Reactions , False Positive Reactions , Female , Flank Pain/diagnostic imaging , Flank Pain/etiology , Humans , Male , Middle Aged , Predictive Value of Tests , Renal Colic/complications , Retrospective Studies , Sensitivity and Specificity , Tomography, X-Ray Computed , Ultrasonography , Urography/methods , Urolithiasis/etiology
19.
Int J Infect Dis ; 14(2): e158-60, 2010 Feb.
Article in English | MEDLINE | ID: mdl-19501533

ABSTRACT

We describe the case of a 29-year-old woman who presented with pancytopenia and myelofibrosis. Brucella melitensis was identified in her blood. The patient recovered completely with doxycycline and rifampin. A repeat bone marrow biopsy showed hypercellularity without myelofibrosis. Bone marrow findings in cases of pancytopenia due to brucellosis reveal normocellularity, hypercellularity, hemophagocytosis, or granuloma. To our knowledge this is the first report of brucellosis causing myelofibrosis. Brucellosis should be considered as a possible cause of myelofibrosis in endemic areas.


Subject(s)
Brucella melitensis/isolation & purification , Brucellosis/complications , Primary Myelofibrosis/etiology , Adult , Biopsy , Bone Marrow/pathology , Brucella melitensis/classification , Brucellosis/microbiology , Doxycycline/therapeutic use , Female , Humans , Pancytopenia/etiology , Pancytopenia/microbiology , Primary Myelofibrosis/microbiology , Rifampin/therapeutic use
20.
Saudi Med J ; 30(8): 1037-43, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19668884

ABSTRACT

OBJECTIVE: To analyze patients with uncommon incidental pseudoaneurysms, secondary to non-catheterization causes, and to discuss the peculiar clinical spectrum, and focus on some aspects of difference from post-catheterization pseudoaneurysms. METHODS: Eleven patients, 8 males and 3 females, were studied retrospectively in Jordan University Hospital, Amman, Jordan, between 2002-2008. Radiological studies performed included duplex sonography (DS), computed tomography (CT), conventional angiography, magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA). RESULTS: Pseudoaneurysms were most commonly encountered in young males (63.6%), especially in the lower limb vessels (36%). Clinical findings were suggestive of pseudoaneurysms in 27% of our cases. Four out of the 8 DS scans showed the neck of pseudoaneurysms, and the to and fro waveform, the strongest indicators for pseudoaneurysms. Both CT with intravenous contrast and angiography failed to establish the diagnosis in one out of 5 cases. The MRI with MRA showed the pseudoaneurysms in 2 patients that underwent the scan. CONCLUSION: Incidental pseudoaneurysms are considered following iatrogenic procedures, penetrating, or blunt traumas with variable delay time. Young healthy males are at increased risks, as opposed to elderly females with calcified vessels in post-catheterization cases. Duplex sonography is less sensitive in incidental than post-catheterization pseudoaneurysms. The CT scan with intravenous contrast has high accuracy in establishing the diagnosis in small, or medium sized pseudoaneurysms. The MRI and MRA are accurate valuable studies and comparable to conventional angiography.


Subject(s)
Aneurysm, False/diagnosis , Aneurysm, False/therapy , Adolescent , Adult , Female , Humans , Leg/blood supply , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Male , Middle Aged , Radiography , Retrospective Studies , Tibial Arteries/diagnostic imaging , Ultrasonography, Doppler, Duplex , Young Adult
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