ABSTRACT
Anterior mediastinal mass often is serious and its diagnosis requires a comprehensive evaluation involving imaging studies, pathological analysis and consultation with a multidisciplinary team involving radiologist, thoracic surgeons, and oncologist.
ABSTRACT
BACKGROUND: Imaging of the kidneys and urinary tract has a significant and critical role for diagnosis of genitourinary system diseases. Although technological progress goes toward less invasive approaches, some of the current methods are still invasive and annoying. Voiding cystourethrography (VCUG) is the best and most accurate method for diagnosis and grading of vesicoureteral reflux. VCUG is a distressful procedure that gives serious anxiety and pain in a large proportion of children and fear for parents; therefore, using effective sedative drugs with the least side effects is necessary and should be considered. MATERIALS AND METHODS: In this review article, importance and efficacy of different drugs before catheterization VCUG be compared in the base of literature survey on EMBASE, PubMed, and Cochrane source. RESULTS: We found that the treatment should be based on nonpharmacological and pharmacological methods; nonpharmacological treatment includes the psychological preparation before procedures as a safety precaution with little or no risk modality, as well as reassuring support. The presence of parents during painful procedures cannot alleviate children distress. Pharmacological methods include oral midazolam (0.5 mg/kg) and intranasal use (0.2 mg/kg) that had been used 10 min before the procedure can effect on anterograde amnesia and sedation without considerable effect on accuracy and grade of reflux. Nitric oxide has a shorter recovery time versus midazolam but has a potential risk for deep sedation and may interfere with the child's voiding phase. CONCLUSION: In summary, oral midazolam of 0.5-0.6 mg/kg or 0.2 mg/kg intranasal is acceptable drug that can be used before VCUG.
ABSTRACT
BACKGROUND: Diabetic men have been claimed to have lower serum free testosterone (FT) concentrations than non-diabetic men. The aim of this study was to investigate if serum FT, luteinizing hormone (LH), and follicle stimulating hormone (FSH) concentrations are different in patients with type 2 diabetes mellitus compared with healthy men and to identify factors associated with low serum testosterone concentrations in men with type 2 diabetes. METHODS: Serum FT, LH and FSH concentrations in 65 men with type 2 diabetes between 50 and 55 years compared with 65 non-diabetic men in Valye-Asr Hospital in Birjand, Iran during October 2009 to August 2010. In addition, the relationships between serum FT concentrations with LH and FSH concentrations as well as other factors including age, fast blood sugar and glycemic control (HbA1C) were investigated. RESULTS: Serum FT concentrations were significantly lower in type 2 diabetic patients (2.53±1.68 pg/ml) than in healthy men (4.29±2.43 pg/ml) (P<0.001). There were not any significant differences in LH and FSH concentrations between the two groups. There was a significant negative relationship between serum FT and HbA1C, but this relation for LH and FSH was positive and non-significant (P<0.001). CONCLUSION: Serum FT concentration is lower in type 2 diabetic patients compared with non-diabetic men suggesting further research to better understand the underlying biologic mechanisms.
