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Evaluation of radiation efficiency of dual source high-pitch (DSHP) chest CT in
comparison to single source technique with special regards to individual
patient anatomy. Methods: 150 consecutive patients who underwent chest CT with
automated tube current modulation were evaluated retrospectively and divided
into three study groups, each with an equal quantity of 50 patients (DSHP vs.
single source 128 slices vs. single source 16 slices). By using a dedicated
workstation, volumetric analyses of each of the scanned anatomic area were
performed and correlated to the individual dose length product (DLP). The
calculated result was defined as dose efficiency. Results: DLP was 203 mGycm
(DSHP), vs. 269 mGycm (single source) vs. 273 mGycm (16 slice CT). The total
patient volume was lowest in the dual source group with 18956.3 cm3 (vs. 22481.2 cm3 vs. 22133.8 cm3). With regards to the
DLP, the calculated dose efficiency of dual source CT was better than the 128
slice CT (p = 0.045) and the 16 slice CT (p < 0.01). Conclusions: DSHP CT
has considerably better dose efficiency compared to 16 slice CT. Compared to
128 slice single source technique, the high-pitch mode does not cause any dose
penalty when performing chest CT.
Introduction: Perinatal testicular torsion is not a frequent, but a
grave finding finding. As only immediate surgical retorsion may save the viability
of the testicle, time is of essence. We report the case of a newborn where
delayed diagnosis led to an unnecessary loss of one testicle. Presentation of
Case: The newborn was presented one day after delivery with a swollen left blue
scrotal pouch. The left testicle was little tender, higher in position and
enlarged. Ultrasound revealed a globular, enlarged testicle left, showing hypodense necrotic areas within. Doppler sound could not detect any perfusion of the spermatic vessels. Scrotal fluid was
present bilaterally. At operation, the testicle was considered unsalvageable,
and left orchiectomy and right orchidopexy were performed. Discussion: In the
new-born, it is more than convenient to perfom ultrasound of both testicles
at the same time, which allows to compare texture and perfusion easily.
Immediate surgical exploration should be performed at any time, even if in diagnostic
doubt. The very most important step though is to professionally recognise and
to react to this pediatric emergency, as time is of paramount essence. Conclusion:
A case of a male newborn with unilateral perinatal testicular torsion is presented,
where typical clinical signs and ultrasound features can be seen. Early
exploration with orchiectomy of the necrotic testicle and orchidopexy of the
healthy side may save the endocrine function and fertility.
It has been suggested that in patients with Parkinson’s disease (PD) metabolism of the MAO-B inhibitor selegiline to methamphetamine may contribute and/or exacerbate sleep problems, possibly leading to deficits of cognition. This open-label exploratory study included 30 PD patients currently being treated with selegiline (7.5 mg/day) and complaining of sleep disturbances. The aim of the study was to determine whether switching from selegiline to another MAO-B inhibitor without amphetamine-like metabolites, namely rasagiline, would improve sleep behaviour and cognitive function in PD patients. Pathologic aberrations as determined by comparison of the frequency pattern of patients to a database consisting of healthy subjects revealed an approximation of electric brain activity to normality. For verification of efficacy, a combination of questionnaires, quantitative source density EEG recording with CATEEMò and performance of two psychometric tasks (d2-test of attention and reading) during the EEG recording were done on the last day of selegiline treatment (7.5 mg/day) as well as 2 and 4 months later, during which the patients were treated with rasagiline (1 mg/day). In addition, performance of the mental tasks revealed a statistically significant (p < 0.05) increase of theta power (4.75 - 6.75 Hz) indicative of improved cognitive abilities at the end of the treatment period. At the same time evaluation of the psychometric test results indicated a statistical improvement with respect to the score of the d2-test (increase from 6.54 to 7.37; p < 0.05). Serum levels of methamphetamine were measured before and after intake of selegiline or rasagiline. They were correlated to alpha2 power, which is under dopaminergic control, within the temporal lobe. From these results it is concluded that the switch from selegiline to rasagiline not only improved sleep behaviour as reported separately but also had a positive effect on electric brain activity and on cognition in these patients.