Background-CT Colonography (CTC) is a non-invasive option for colorectal cancer (CRC) screening. The accuracy of CTC as a screening tool among asymptomatic adults has not been well defined.
Febrile morbidity is the most commonly reported adverse event after hysterectomy. Its incidence ranges from 9.1 to 37.4%. Risk factors reported in the literature include prolonged operative time, history of previous surgery, higher parity, greater blood loss, abdominal approach, and no antibiotic prophylaxis.Antibiotic prophylaxis in abdominal hysterectomy may provide protection against febrile morbidity and reduce its incidence, but does not eliminate it. Limited data are available evaluating risk factors for febrile morbidity after hysterectomy. This historical cohort study assessed the incidence of febrile morbidity and associated risk factors in 1980 Thai women, who had an abdominal hysterectomy between 1998 and 2005.Of the 1980 women, febrile morbidity occurred in 517. This represents an overall incidence of 26.1%. Univariate analysis of potential risk factors showed that the incidence of febrile morbidity was higher in patients with lower preoperative hematocrit, more extensive surgery, longer operative time, greater intraoperative blood loss and malignant disease. Median intraoperative blood loss was lower in the nonfebrile group than the febrile group (400 versus 500 ml, P Յ .0005) and median operative time was shorter (135 versus 150 minute, P Յ .0005).When both pre and postoperative variables were included in the logistic regression model, the only two risk factors independently associated with febrile morbidity were intraoperative blood loss of Ն750 ml (odds ratio [OR],1.52; 95% confidence interval [CI], 1.08-2.13; P ϭ .036) and a diagnosis of malignant disease (OR 1.86; 95% CI 1.45-2.13, P Ͻ .0005). GYNECOLOGY Volume 64, Number 1 OBSTETRICAL AND GYNECOLOGICAL SURVEY ABSTRACTAlternatives to hysterectomy such as medical treatment, uterine artery embolization (UAE), and ablative therapy have become available and widely used in the last 10 years. It is unclear if these alternatives are replacing hysterectomy or delaying it. To determine the effect of patient clinical factors on the utilization of hysterectomy and alternatives of hysterectomy, the investigators examined all claims relating to a hysterectomy procedure or a hysterectomy-associated diagnosis in the database of a large insurance provider for 48 consecutive months from 2001 to 2005. A total of 295,148 claim lines were abstracted and analyzed by CPT and diagnostic grouping codes.Of the 7049 procedures represented in the claim lines, 1972 were hysterectomies and 5077 were hysterectomy alternatives. The mean age of patients filing claims was 39.1 years. Patients submitting claims for a hysterectomy were older than those having an alternative procedure (mean age, 49.7 v 46.0 years, P Ͻ .0001). The diagnostic group associated with the majority of all claims was abnormal bleeding (33%); the inflammation/mass/pain/endometriosis group accounted for 32%. The most common diagnostic groups associated with a hysterectomy were fibroids (39.4%), the inflammation/mass/pain/endometriosis category (14.7%), and cancer (13.0%). Bleeding represented the majority o...
Objective. The purpose of this presentation is to review the techniques of performing an upper extremity Doppler examination, in addition to illustrating the sonographic appearances of acute and chronic upper extremity deep venous thrombosis (UEDVT). Methods. The risk factors and complications of UEDVT are discussed, and the anatomy of the upper extremity deep venous system as well as examination techniques are described. Cases of acute and chronic deep venous thrombosis were also chosen to illustrate the spectrum of sonographic appearances. Results. Color Doppler sonography is accurate in the diagnosis of UEDVT. However, in cases of equivocal Doppler findings, or when the sonographic findings are normal but clinical suspicion for central venous thrombosis is high, magnetic resonance or contrast venography is necessary for further evaluation. Conclusions. Color Doppler sonography is a rapid and noninvasive technique in the evaluation of venous disease in the upper extremity and is the modality of choice in screening for UEDVT.
Assuming US is the initial imaging examination, when occlusion is diagnosed, MR angiography can depict it. If occlusion is confirmed, no further imaging is necessary. US performed well in helping to differentiate vessels with focal severe stenosis from those with diffuse disease. MR angiography added little in this group. Catheter angiography remains beneficial for vessels with diffuse nonfocal narrowing.
Doppler US is excellent for classifying stenoses as above or below a single degree of severity but does not function well in stenosis subclassification.
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