EEG is A Predictor of Neuroimaging Abnormalities in Pediatric Extracorporeal Membrane Oxygenation.

The goal of this project was to evaluate if severity of electroencephalogram (EEG) during or shortly after being placed on extracorporeal membrane oxygenation (ECMO) would correlate with neuroimaging abnormalities, and if that could be used as an early indicator of neurologic injury. This was a retrospective chart review spanning November 2009 to May 2018. Patients who had an EEG recording during ECMO or within 48 hours after being decannulated (early group) or within 3 months of being on ECMO (late group) were included if they also had ECMO-related neuroimaging.

Antibiotic Stewardship Challenges in a Referral Neonatal Intensive Care Unit.

Background: Antibiotic overuse in neonates is associated with adverse outcomes. Data are limited to guide antibiotic stewardship in the neonatal intensive care unit (NICU). Our objective was to identify areas for antibiotic stewardship improvement in a referral NICU.

Defecography: does parity play a role in the development of rectal prolapse?

Few studies related to parity address the changes in anorectal function in women. Since the majority of patients with rectal prolapse are women, we undertook this study to assess the role of parity in the development of rectal prolapse. We retrospectively reviewed defecography studies performed on 354 female patients over a 10-year period.

The role of parity and hysterectomy on the development of pelvic floor abnormalities revealed by defecography.

Objective: The purpose of our study was to assess the role of multiparity and pelvic surgery, especially hysterectomy, on pelvic floor dysfunction as diagnosed on defecography.

Materials And Methods: Three hundred fifty-four women who underwent defecography between 1986 and 1996 were asked to provide information regarding obstetric history and pelvic surgery. Responses were obtained from 272 women (response rate, 77%).

Is constipation a disorder of defecation or impaired motility?: distinction based on defecography and colonic transit studies.

Objective: The purpose of this study was to determine whether constipation is a disorder of defecation or of impaired motility by using defecography and transit studies.

Materials And Methods: Thirty-five patients (34 women, one man) with severe constipation underwent defecography and colonic transit studies in a 2-month period. Transit studies included the use of orally administered radiopaque markers and plain abdominal radiographs obtained up to 4 days later.

Cutaneous ileocystostomy (a bladder chimney) for the treatment of severe neurogenic vesical dysfunction.

The aim of this study was to investigate the efficacy and morbidity of cutaneous ileocystostomy, as an alternative to cystectomy and ileal conduit urinary diversion, for patients with end-stage neurogenic vesical dysfunction. Three male and eight female patients, mean age 41 years (range 28-59), with a mean duration of a neuropathic bladder of 8 years (range 4-17 years) underwent evaluation for ileocystostomy urinary diversion. Indications for the procedure included a bladder capacity < or = 200 ml (10 patients), recurrent febrile urinary tract infection (nine patients), and urinary incontinence despite an indwelling urethral catheter (all eight women).

Esophageal strictures: findings on barium radiographs.

An esophageal stricture is a narrowing of the lumen due to inflammation or tumor. Lack of distensibility is characteristic of stricture, which may be diffuse or localized and which may have abrupt or tapered margins. The purpose of this essay is to illustrate the imaging features of various types of strictures, focusing on their value in differential diagnosis.

Improved quality of life and sexuality with continent urinary diversion in quadriplegic women with umbilical stoma.

Quality of life issues prompted us to offer continent urinary diversion to quadriplegic women who required cystectomy for end-stage neurogenic vesical dysfunction complicated by urethral destruction as a result of chronic indwelling catheterization. Three women with spinal cord injury (SCI) and resultant quadriplegia of 5 to 15 years duration underwent continent urinary diversion. Preoperative evaluation and urodynamic studies in each showed a bladder capacity of less than 150mL, bilateral vesicoureteral reflux, recurrent febrile urinary tract infections, an incompetent urethral sphincter, and incontinence around an indwelling catheter in all three patients.

Trends in use of barium enema examination, colonoscopy, and sigmoidoscopy: is use commensurate with risk of disease?

Purpose: To assess replacement of barium enema examination with colonoscopy in relation to age- and sex-related risk factors, place of service, physician specialty, and cost.

Materials And Methods: Between 1985 and 1992, 894,777 insurance claims for barium enema examination and lower gastrointestinal endoscopy were retrospectively examined. Changes in use were investigated.

Intraoperative endo-luminal ultrasound evaluation of urethral diverticula.

The imaging accuracy of a catheter-based endo-luminal ultrasound system was compared to traditional imaging techniques for surgical treatment of urethral diverticula in 7 women and 1 man. At surgical repair the urethra was catheterized directly with a 6.2F or 9F (12.

Functional urethral closure with pubovaginal sling for destroyed female urethra after long-term urethral catheterization.

Objective: To assess the pubovaginal sling as therapy for correction of the destroyed female urethra secondary to long-term indwelling Foley catheter management of neurogenic vesical dysfunction.

Methods: Fourteen women with neurologic disease and a patulous and nonfunctioning urethra underwent pubovaginal sling functional urethral closure. The purpose of the procedure is to achieve a dry perineum.

Prospective comparison of external sphincter balloon dilatation and prosthesis placement with external sphincterotomy in spinal cord injured men.

The purpose of our investigation was to compare external sphincterotomy, the traditional method of treatment of detrusor-external sphincter dyssynergia (DESD), with two newer methods, balloon dilatation or internal stenting of the external sphincter. Sixty-one spinal cord injured (SCI) men were prospectively evaluated. The indications for treatment were DESD and voiding pressure greater than 60 cmH2O demonstrated during video-urodynamic study.

Cost containment in the use of low-osmolar contrast agents: effect of guidelines, monitoring, and feedback mechanisms.

Purpose: To describe a program for controlling intravenous use of low-osmolar contrast agents (LOCAs).

Materials And Methods: The department of radiology at the authors' institution adopted a policy of selective use of intravenously administered LOCAs. Clinical indications for LOCA use were specified after consultation with the administration, risk managers, legal department, and ethics committee of the hospital.

Transurethral balloon dilation of the external urinary sphincter: effectiveness in spinal cord-injured men with detrusor-external urethral sphincter dyssynergia.

The authors investigated balloon dilation as a minimally invasive alternative to transurethral external sphincterotomy for the treatment of detrusor-external urethral sphincter dyssynergia (DESD). Seventeen spinal cord-injured men with voiding pressures greater than 60 cm H2O underwent balloon dilation of the external sphincter to 90 F at 4 atm of pressure for 10 minutes. The mean voiding pressures before and 12 months after dilation were 83 cm H2O +/- 35 and 37 cm H2O +/- 15, respectively (P = .

Hysterosalpingography before and after myomectomy: clinical value and imaging findings.

Objective: Myomectomy is being performed increasingly for the treatment of menorrhagia and infertility. The purpose of this study was to describe the findings at hysterosalpingography before and after myomectomy and to correlate the findings with the operative technique and observations at surgery. This study also examined the value of hysterosalpingography in planning surgery, as well as in detecting postoperative complications and residual fibroids.

Functional disorders of the anus and rectum: findings on defecography.

In the past decade, interest in the anorectal region and the mechanism of continence and defecation has been increasing. Subsequently, techniques to visualize the anorectum have been introduced; evacuation proctography and defecography have been used to describe the dynamic radiologic evaluation of this area. Also, developments in anorectal manometry, electromyography, and transrectal sonography have renewed interest in defecography, particularly in categorizing the functional disorders including rectocele, intussusception and prolapse, enterocele, descending perineum syndrome, dyskinetic puborectalis muscle, solitary rectal ulcer syndrome, and incontinence.

Imaging of uterine leiomyomas.

Advances in the medical and surgical treatment of uterine leiomyomas have stimulated interest in the imaging of these common tumors. The purpose of this essay is to illustrate the appearance of leiomyomas on images obtained with various techniques. The advantages of each technique in particular clinical circumstances are discussed.

Giant cell tumor of tendon sheath: spectrum of radiologic findings.

Giant cell tumor of tendon sheath is the second most common tumor of the hand. It can also occur in larger joints. Radiologic features include a soft-tissue mass with or without osseous erosion.

Hysterosalpingography.

During the past decade, there has been a dramatic increase in the number of women seeking infertility evaluation. Hysterosalpingography (HSG) is an invaluable procedure for evaluating internal architecture of the female reproductive tract. Utilizing HSG, it may be possible to minimize the use of invasive procedures, such as hysteroscopy and laparoscopy, in defining such problems as peritubal adhesions, leiomyomas, and congenital anomalies.

The value of hysterosalpingography before reversal of sterilization procedures involving the fallopian tubes.

Knowledge of the length of the uterine end of the fallopian tube and the presence of tubal adhesions and fistulas is important when surgical reversal is undertaken in patients who have had tubal ligation. We retrospectively studied hysterosalpingograms in 127 such patients to determine their value in providing this information. The ligation was performed by using the Pomeroy technique in 57 patients.

Peritubal adhesions in infertile women: diagnosis with hysterosalpingography.

We studied the efficacy of hysterosalpingography in the detection of peritubal adhesions without tubal occlusion by using laparoscopy as the gold standard for the diagnosis. Peritubal adhesions were diagnosed on hysterosalpingography by using the following radiographic criteria alone or in combination: (1) convoluted fallopian tube, (2) loculation of spillage of contrast medium into the peritoneal cavity, (3) ampullary dilatation, (4) peritubal halo effect (double-contour appearance of the tubal wall), and (5) vertical fallopian tube. The first 100 patients with the diagnosis of adhesions on hysterosalpingography who also had laparoscopy were included in the study.