ABSTRACT
A limited body of evidence suggests that sleep problems are common in prostate cancer patients undergoing androgen deprivation therapy, yet little is known about sleep characteristics and the effects of poor sleep on daily functioning in this population. This study assessed sleep in 60 prostate cancer patients taking androgen deprivation therapy with wrist actigraphy and daily diaries for 7 days. The Epworth Sleepiness Scale and the general version of the Functional Assessment of Cancer Therapy scale were also administered. On average, total sleep time was 5.9 (SD = 1.4) h, and sleep efficiency was 75% (SD = 12.0) as assessed by actigraphy. There was generally poor concordance between actigraphy and daily diary for most sleep metrics. Subjects reported awakening, on average, 2.7 times per night, most commonly for nocturia and hot flashes. Assessment of daily functioning showed that participants had mild daytime sleepiness, which was predicted by total sleep time (F(1,47) = 4.5, P= 0.04) General quality of life was not impaired. This study supports more research on the predictors of poor sleep in order to identify effective interventions.
Subject(s)
Androgen Antagonists/adverse effects , Prostatic Neoplasms/drug therapy , Quality of Life , Sleep Wake Disorders/chemically induced , Aged , Aged, 80 and over , Androgen Antagonists/therapeutic use , Hot Flashes/chemically induced , Humans , Male , Middle Aged , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Four cases are reported, along with a review of the literature, to demonstrate the radiographic and clinial spectrum of bilateral anteromedial defect of the diaphragm in infants and children. Bilateral anteromedial defect of the diaphragm produces a characteristic radiographic pattern on herniation of abdominal structures through a single midline opening. The usually solid herniated structures elevate the heart and thymus producing a three-tiered snowman appearance. The lateral chest view substantiates the anterior location differentiating anteromedial herniation from eventration, partial or complete. Diagnosis can be confirmed by pneumoperitoneography but the high incidence of liver herniation allows less invasive determination by radionuclide scanning. While many patients will be asymptomatic, clinical symptoms can be severe due to pulmonary compression and hypoplasia or associated cardiovascular abnormalities.
Subject(s)
Hernia, Diaphragmatic/diagnostic imaging , Child , Heart Defects, Congenital/complications , Hernia, Diaphragmatic/embryology , Hernias, Diaphragmatic, Congenital , Humans , Infant, Newborn , Male , PneumoradiographySubject(s)
Budd-Chiari Syndrome/diagnostic imaging , Adult , Humans , Liver/diagnostic imaging , Male , Radionuclide Imaging , TechnetiumABSTRACT
The thyroid traps the pertechnetate ion and iodine in a similar manner. Thus, 99mTc-pertechnetate may be used for thyroid uptake studies (including stimulation and suppression tests)8 as well as imaging. Images are obtained after an intravenous administration of 2--4 mCi of 99mTc-pertechnetate, and the scan is preceded by a trapping index at 20 minutes, measured as the neck to thigh ratio. In 1973, we compared 99mTc-pertechnetate with 131I in diagnostic uptake and imaging studies of the thyroid gland in 100 patients. We have had experience with an additional 100 patients, and modified our procedure so that the Anger camera with pinhole collimator will adequately replace the standard scintillation probe. Using the camera alone, with the 99mTc-pertechnetate makes the study less expensive and briefer, with no loss of information. Routine use of the scan aids in distinguishing diffuse from localized diseases.
Subject(s)
Technetium , Thyroid Gland/diagnostic imaging , Evaluation Studies as Topic , Humans , Iodine Radioisotopes/metabolism , Methods , Radionuclide Imaging , Technetium/metabolism , Thigh/metabolism , Thyroid Diseases/diagnostic imaging , Thyroid Diseases/metabolism , Thyroid Gland/metabolism , Time FactorsABSTRACT
Three cases of suspected acute suppurative lesions of the renal cortex treated successfully with antimicrobial agents are presented. In support of other reports it appears that selected cases, particularly when diagnosed early, may be managed conservatively without surgical drainage. In those cases of severe sepsis, large intrarenal or perinephric abscesses, resistant organisms or those that are refractory to treatment, surgical intervention may be unavoidable. Gallium-67 nuclear scanning is a safe, non-invasive method of locating rapidly these areas of inflammation and has proved to be a useful tool in earlier diagnosis.
Subject(s)
Bacterial Infections/diagnostic imaging , Gallium Radioisotopes , Nephritis/diagnostic imaging , Adolescent , Adult , Bacterial Infections/drug therapy , Escherichia coli Infections/diagnostic imaging , Escherichia coli Infections/drug therapy , Evaluation Studies as Topic , Female , Humans , Kidney Cortex , Nephritis/complications , Nephritis/drug therapy , Pseudomonas Infections/diagnostic imaging , Pseudomonas Infections/drug therapy , Pyelonephritis/complications , Radionuclide ImagingSubject(s)
Abscess/diagnostic imaging , Carcinoma, Squamous Cell/diagnostic imaging , Gallium Radioisotopes , Muscles/diagnostic imaging , Neoplasm Metastasis/diagnostic imaging , Uterine Cervical Neoplasms/diagnostic imaging , Carcinoma, Squamous Cell/radiotherapy , Diagnosis, Differential , Female , Humans , Leg , Middle Aged , Necrosis , Radionuclide Imaging , Uterine Cervical Neoplasms/radiotherapyABSTRACT
A case of anaerobic bacterial hepatic abscess presenting as a "cold" lesion with 67Ga is presented. Its implications in the differential diagnosis and overreliance in metronidazole treatment are discussed.
Subject(s)
Bacterial Infections/diagnostic imaging , Liver Abscess/diagnostic imaging , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/drug therapy , Bacterial Infections/surgery , False Negative Reactions , Gallium Radioisotopes , Humans , Liver Abscess/drug therapy , Liver Abscess/surgery , Male , Middle Aged , Radionuclide Imaging , TechnetiumABSTRACT
Seven patients showing a localized area of increased uptake (hot spot) on 99mTc sulfur colloid liver scans are described. Four also had dynamic studies. In five patients the hot spot was associated with superior vena caval obstruction, in one it was associated with inferior vena caval obstruction, and in one with a hepatoma. Although a hot spot on static liver images usually indicates superior vena caval obstruction, the addition of radionuclide venacavography is recommended to confirm the diagnosis. A hot spot in the liver area in a radionuclide venogram of the lower limbs suggests inferior vena caval obstruction with collaterals via the liver.
Subject(s)
Radionuclide Imaging , Vena Cava, Superior , Carcinoma, Hepatocellular/diagnosis , Collateral Circulation , Diagnosis, Differential , Humans , Liver/blood supply , Liver Neoplasms/diagnosis , Vascular Diseases/diagnosisSubject(s)
Erythrocytes , Radionuclide Imaging , Splenic Rupture/diagnosis , Technetium , Hematoma/diagnosis , Humans , Male , Middle Aged , Splenic Diseases/diagnosisABSTRACT
A 4 1/2-year-old girl with S-S sickle-cell anemia was found to have papillary necrosis on excretory urography. This is believed to be the first reported case of papillary necrosis in a child with homozygous S-S sickle-cell anemia.