A comparison between digital fluoroscopic hard copies and 105-mm spot films in evaluating vesicoureteric reflux in children.

OBJECTIVE: To compare fluoroscopic freeze-frame digital images with conventional 105-mm spot films during voiding cystourethrography (VCUG) with regard to diagnostic quality and radiation dose. MATERIALS AND METHODS: VCUG was performed on 57 consecutive children by a commercially available fluoroscopic digital system. Both freeze-frame digital images and conventional 105-mm spot films were obtained during 90 s of fluoroscopy. Skin radiation dose was assessed separately for spot films and for both fluoroscopy and spot films, employing thermoluminescent crystals on the anterior surface of the body. Patients were classified into three age groups: group A younger than 12 months, group B 1-5 years old and group C 5-12 years of age. RESULTS: Digital and conventional images provided diagnostically identical results in 108 out of 114 ureters examined (94.7%). Percentage reductions in skin radiation dose due to the fluoroscopic hard copies compared with the four 105-mm radiographs were 53.8%, 50.5% and 57.1% for groups A, B and C, respectively. CONCLUSION: Substitution of conventional 105-mm spot films during VCUG with digital fluoroscopic hard copies resulted in a substantial reduction in radiation dose. Digital images were as accurate as the conventional films in excluding vesicoureteric reflux (VUR). The two methods correlated well in diagnosing and grading VUR.

[Dynamic ultrasonography in the assessment of candidates to laparoscopic cholecystectomy]. / L'ultrasonografia dinamica nella valutazione del candidato alla colecistectomia laparoscopica.

Laparoscopic surgery has opened a new era in the management of surgical diseases. But, on the other hand, has created problems relating to the technological and to the technico-surgical aspects. In the preoperative evaluation of laparoscopic cholecystectomy candidates it is very important to know about the pathological state of the gallbladder, which may become the cause of very difficult or impossible laparoscopic operation, and the convert in an open procedure will be forced. Recurrent gallbladder inflammations provoke alterations of the normal structure of the wall (oedema, fibrosis) and normal elasticity and contraction after stimulation is last. Adhesion with neighbouring organs hinder contraction as well, and surgical difficulties increase. Choledocholithiasis must be known before operation, to plan surgical strategy. The presence of choledochus disease does that allow us to modify its calibre after stimulation. 100 patients who underwent laparoscopic cholecystectomy, in our Department, were evaluated before with dynamic ultrasonography (DUS), and the results were compared with operating finds. In this paper are exposed the used method of evaluation and the results of this work. These results allow as to state that the method is effective and trustworthy.

Nutrition status of the elderly in Anogia, Crete, Greece.

General health and nutritional status of 167 free-living elderly Greek (aged 65-91 years) were assessed. The most prevalent diseases/symptoms encountered were related to respiratory, gastrointestinal, musculoskeletal and vascular systems (hypertension). Most subjects were socially active. Body mass index was < 20 and > 25 Kg/m2 in 7 and 57% of the subjects, respectively. Systolic blood pressure was significantly higher in women than in men, and as a group, 18 and 42%, respectively, had diastolic blood pressures > 90 and systolic blood pressures > 160 mmHg. Anemia and hypoalbuminemia were detected in < 5% of the population. Total fat intake was 40-45% of total energy intake and most of it came from monounsaturated fat. Hypercholesterolemia (> 6 mmol/L) was present in 32% of subjects. The percentages of men who smoked (66%) or drank (68%) were significantly higher than those of women (2 and 1%, respectively). Dietary intake data were compared with US recommended dietary allowances (RDA) for elderly. Daily energy and protein intakes were lower than the US RDA levels; calcium intake was > 50% of the US RDA, while magnesium and vitamin B6 levels were < 50% of the US RDA. Vitamin C intake was much higher than that of the US RDA. Mean thiamin, vitamin A, riboflavin and iron intakes were below the US RDA, while fiber intake was < 50% of the corresponding US estimate. Phosphorus was higher than the US RDA in men, while lower for women. Sodium intakes exceeded those recommended, while potassium levels were higher than those recommended in males, and lower in females.(ABSTRACT TRUNCATED AT 250 WORDS)