ABSTRACT
OBJECTIVE: Müllerian duct anomalies can adversely affect pregnancy outcomes and can result in clinical symptoms. This article will review the appropriate management of patients with müllerian duct abnormalities. CONCLUSION: Whereas uterine and vaginal septa, vaginal agenesis, and unicornuate uterus can be managed surgically, other uterine anomalies tend to be managed clinically. Hence, appropriate management depends on a reliable assessment of pelvic anatomy. MRI can accurately display female pelvic anatomy and is, therefore, useful in guiding therapy.
Subject(s)
Magnetic Resonance Imaging/methods , Mullerian Ducts/abnormalities , Pregnancy Complications/diagnosis , Urogenital Abnormalities/diagnosis , Female , Humans , Pregnancy , Pregnancy Complications/surgery , Pregnancy Outcome , Sensitivity and Specificity , Urogenital Abnormalities/surgeryABSTRACT
PURPOSE: CT radiation exposure has come under increasing scrutiny because of dramatically increased utilization. Multiphase CT studies (repeated scanning before and after contrast injection) are a potentially important, overlooked source of medically unnecessary radiation because of the dose-multiplier effect of extra phases. The purpose of this study was to determine the frequency of unindicated multiphase scanning and resultant excess radiation exposure in a sample referral population. METHODS: Abdominal and pelvic CT examinations (n = 500) performed at outside institutions submitted for tertiary interpretation were retrospectively reviewed for (1) the appropriateness of each phase on the basis of clinical indication and ACR Appropriateness Criteria(®) and (2) per phase and total radiation effective dose. RESULTS: A total of 978 phases were performed in 500 patients; 52.8% (264 of 500) received phases that were not supported by ACR criteria. Overall, 35.8% of phases (350 of 978) were unindicated, most commonly being delayed imaging (272 of 350). The mean overall total radiation effective dose per patient was 25.8 mSv (95% confidence interval, 24.2-27.5 mSv). The mean effective dose for unindicated phases was 13.1 mSv (95% confidence interval, 12.3-14.0 mSv), resulting in a mean excess effective dose of 16.8 mSv (95% confidence interval, 15.5-18.3 mSv) per patient. Unindicated radiation constituted 33.3% of the total radiation effective dose in this population. Radiation effective doses exceeding 50 mSv were found in 21.2% of patients (106 of 500). CONCLUSIONS: The results of this study suggest that a large proportion of patients undergoing abdominal and pelvic CT scanning receive unindicated additional phases that add substantial excess radiation dose with no associated clinical benefit.
Subject(s)
Radiation Dosage , Radiation, Ionizing , Radiography, Abdominal/adverse effects , Tomography, X-Ray Computed/adverse effects , Unnecessary Procedures , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Child , Child, Preschool , Confidence Intervals , Cross-Sectional Studies , Female , Humans , Infant , Male , Middle Aged , Pelvis/diagnostic imaging , Radiation Effects , Radiography, Abdominal/standards , Risk Assessment , Tomography, X-Ray Computed/standards , United States , Young AdultABSTRACT
Candida biofilm formation is common during infection and environmental growth. We tested the impacts of three biocides (ethanol [EtOH], H(2)O(2), and sodium dodecyl sulfate) on Candida albicans, C. parapsilosis, and C. glabrata biofilms. Higher concentrations of the biocides were required for efficacy against biofilms than for efficacy against planktonic controls. A combination study with two biocides (EtOH and H(2)O(2)) and fluconazole demonstrated that the combination had enhanced efficacy.
